Simultaneous biplanar fluoroscopy for the surgical treatment of slipped capital femoral epiphysis

Background: The current standard of care for treatment of slipped capital femoral epiphysis (SCFE) is in situ placement of a single, cannulated screw across the physis under direct fluoroscopic guidance. Previous studies have reported the theoretical advantages of shorter operative time and improved accuracy of screw placement when 2 fluoroscopy units are used simultaneously. Methods: A retrospective review was performed to compare the use of 1 versus 2 C-arms in the surgical stabilization of SCFE. Data analysis, including demographics, surgical setup times, operative times, and precision of screw placement was performed in 77 consecutive hips (69 patients). Results: No significant differences were found between the single and dual C-arm techniques with respect to operating room setup and surgery times. Center-center positioning of the screw was more precise when using the simultaneous dual C-arm technique. Surgical times were longer in obese children, irrespective of the number of C-arms used. Conclusions: Efficient operating room setup time for the dual C-arm technique is possible. Precision of screw placement is improved when using simultaneous biplanar fluoroscopy for the in situ pinning of SCFE. Level of Evidence: Level IV.