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    DrSheenam Bansal
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    SLIPPED CAPITAL FEMORAL EPIPHYSIS

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    SCFE TACHDIJAN

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    SLIPPED CAPITAL FEMORAL EPIPHYSIS

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    Download as pdf
    12 views20 pages

    Scfe Tachdijan

    Uploaded by

    DrSheenam Bansal
    SLIPPED CAPITAL FEMORAL EPIPHYSIS

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    Download as pdf
    of 20
    46 SECTION | Hip Disorders A, The ideal position of a is in the Sato itn pepo he In this position, stabilization of the epipl eck is maximal and the risk is lowest for inadvertent penetration of the screw into the joint, Because of the typical posterior dis- lacement of the femoral epiphysis on t femoral neck in most cases. The exact location varies with the severity of the slip. ‘The patient is positioned on the fracture table with the patella facing anteriorly and the limb in neutral to light abduction, In the eae of unstable slips, the epiphysis will usually be noted to have reduced to some extent in this position. No further efforts at reduction should be made. ‘The opposite limb can be placed in traction and maximum abduction, or flexed and abducted to clear it from the lateral fluoroscopic projection. Proper functioning of the fuoroscope with adequate anteroposterior (AP) and lateral visualization of the femoral epiphysis should be confirmed at this time. The C-arm fluoroscope is then draped out of the surgical field G, The ideal trajectory marked 0: patient's skin by placing while assessing the position of the copy on both the AP and lateral projections. The intersec- tion of these two lines indicates the proper point of insertion of the guidewire into the patient's limb. A stab incision in, the skin is made at this point. PROCEDURE 13 Percutaneous Cannulated Screw Fixation ("Pinning") of Slipped Capital Femoral Epiphysis 47 D, Under fluoroscopic guidance, and following the trajectories marked on the patient's skin, the guidewire is pushed onto the base of the femoral neck, then advanced into the neck, across the physi, and into the epiphysis. Ifthe location of the guidewire is not idea, it should be repositioned, or temporarily left in place as a guide for the insertion of a second guidewire in th provides some rotational. stl case of unstable slips and can be used for the insertion of a second cannulated screw if desired, E, The length of guidewire inserted into the bone is measured either with the arbi the femoral neck rea

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