ArticleBMC musculoskeletal disorders2025
Double versus single fluoroscopy for screw fixation of slipped capital femoral epiphysis: does double fluoroscopy improve outcomes? A retrospective comparative study.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to evaluate the effect of using simultaneous double fluoroscopy, which provides anteroposterior (AP) and lateral images concurrently, on screw placement accuracy, surgical duration, and radiation exposure in the treatment of slipped capital femoral epiphysis (SCFE).
methodsA retrospective study was conducted on 92 patients (73 males, 19 females; mean age 12.78 ± 1.54 years) who underwent in situ screw fixation for SCFE between 2017 and 2024. Patients were divided into two groups according to intraoperative imaging technique: single fluoroscopy (Group 1, n = 44) and double fluoroscopy (Group 2, n = 48). Demographic, operative, and radiographic parameters were compared between groups. Screw entry point and physeal fixation were graded in both AP and lateral planes.
resultsThere were no significant differences in demographic or preoperative radiological parameters between groups (p > 0.05). The mean preparation time was less in Group 1 (9.68 ± 1.83 min) compared to Group 2 (17.38 ± 1.93 min, p < 0.001). However, the surgical time was significantly longer in Group 1 (37.64 ± 10.68 min) compared to Group 2 (23.06 ± 6.45 min, p < 0.001). The total operation time was extended in Group 1 (47.32 ± 10.92 min) than in Group 2 (40.44 ± 6.68 min, p < 0.001). The mean fluoroscopy time was also longer in Group 1 (44.46 ± 9.15 s) than in Group 2 (39.73 ± 8.03 s, p = 0.01). Radiographic analysis revealed superior screw positioning in the double fluoroscopy group, with significantly higher rates of optimal entry points in the lateral plane (p = 0.004) and improved physeal fixation in both AP (p = 0.036) and lateral (p = 0.019) planes. Complication rates were lower in Group 2 (2%) compared to Group 1 (9%).
conclusionsSimultaneous double fluoroscopy during screw fixation of SCFE was associated with improved screw placement accuracy, reduced radiation exposure, and shorter total operative time, despite requiring slightly longer preparation. This method appears to be a reliable and effective technique that can enhance surgical precision and safety in hip surgery.
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