A Simple Modification for In Situ Pinning in Slipped Capital Femoral Epiphysis on a Radiolucent Table to Reduce...

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Skeletal Dysplasias

Background:

• In situ pinning is the standard treatment for mild to moderate slipped capital femoral epiphysis (SCFE).
• Technical challenges, particularly in overweight patients, can complicate traditional pinning procedures.
• A modified technique using a bone marrow biopsy needle system for guidewire navigation was investigated.

Purpose of the Study:

• To compare the efficacy and safety of using a bone marrow biopsy needle system versus the traditional technique for guidewire insertion in SCFE surgery.
• To evaluate operative time, radiation exposure, and screw accuracy between the two methods.

Main Methods:

• A retrospective comparative study included 28 patients (34 hips) with stable mild-moderate SCFE treated between 2022 and 2024.
• Patients were divided into two groups: Group 1 (bone marrow biopsy needle system for guidewire navigation) and Group 2 (traditional guidewire insertion).
• Clinical, surgical, and radiographic data were analyzed.

Main Results:

• No significant differences were observed in patient demographics or baseline characteristics between the groups.
• Group 1 demonstrated significantly shorter operative times (P=0.003) and reduced fluoroscopy usage (P=0.001) compared to Group 2.
• Screw accuracy was comparable between the groups in both anteroposterior and lateral planes, with no reported complications.

Conclusions:

• Navigating the cannulated screw guidewire with a bone marrow aspirate needle is a cost-effective modification for in situ pinning in SCFE.
• This technique enhances femoral entry point determination, prevents guidewire bending/breakage, and leads to reduced operative time and radiation exposure.