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Background <p>This 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).</p> Methods <p>A 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, <i>n</i> = 44) and double fluoroscopy (Group 2, <i>n</i> = 48). Demographic, operative, and radiographic parameters were compared between groups. Screw entry point and physeal fixation were graded in both AP and lateral planes.</p> Results <p>There were no significant differences in demographic or preoperative radiological parameters between groups (<i>p</i> &gt; 0.05). The mean preparation time was less in Group 1 (9.68 ± 1.83&#xa0;min) compared to Group 2 (17.38 ± 1.93&#xa0;min, <i>p</i> &lt; 0.001). However, the surgical time was significantly longer in Group 1 (37.64 ± 10.68&#xa0;min) compared to Group 2 (23.06 ± 6.45&#xa0;min, <i>p</i> &lt; 0.001). The total operation time was extended in Group 1 (47.32 ± 10.92&#xa0;min) than in Group 2 (40.44 ± 6.68&#xa0;min, <i>p</i> &lt; 0.001). The mean fluoroscopy time was also longer in Group 1 (44.46 ± 9.15&#xa0;s) than in Group 2 (39.73 ± 8.03&#xa0;s, <i>p</i> = 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 (<i>p</i> = 0.004) and improved physeal fixation in both AP (<i>p</i> = 0.036) and lateral (<i>p</i> = 0.019) planes. Complication rates were lower in Group 2 (2%) compared to Group 1 (9%).</p> Conclusions <p>Simultaneous 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.</p>

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Double versus single fluoroscopy for screw fixation of slipped capital femoral epiphysis: does double fluoroscopy improve outcomes? A retrospective comparative study

  • 期刊论文

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  • 发表日期：

    2025年12月17日

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  • Tayfun Bacaksız,
  • Melikşah Uzakgider,
  • Mehmet Maden,
  • Özgür Doğan Aydın,
  • Ihsan Akan,
  • Fatih Sürenkök,
  • Cemal Kazımoğlu

摘要

Background

This 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).

Methods

A 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.

Results

There 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%).

Conclusions

Simultaneous 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.