POSITION study

Background

Slipped capital femoral epiphysis (SCFE) is a disorder of the proximal femur that affects children around the pubertal age. A displacement through the proximal femoral physis occurs; typically the proximal femoral neck and shaft moves anteriorly and rotates externally relative to the femoral head. 

´╗┐Primary treatment of SCFE mainly consist of in situ pinning, to prevent progressive deformity. After this treatment however, an alteration of the proximal femoral morphology usually remains, resulting in femoroacetabular impingement (FAI). This often leads to symptoms and early osteoarthritis, which is reflected by the finding that SCFE is 1 of the most common reasons for hip replacement surgery in adolescence and early adulthood. 

It is known that after in situ pinning, during further growth the shape of the proximal femur can gradually change up to skeletal maturity, a process called remodeling.3 Furthermore, it is known that details on screw type and placement can have influence on residual growth and remodeling in SCFE patients. Nevertheless, to date no detailed analysis of the influence of screw positioning on remodeling after in situ fixation for SCFE has been reported. 

Objective

This study aims to quantify remodeling of the proximal femur after in situ pinning for SCFE, and identify the influence of transphyseal screw positioning and other predictors on the amount of remodeling that can be expected up to skeletal maturity