Femoral Neck Growth and Remodeling After Screw Removal Following Slipped Capital Femoral Epiphysis
DOI:
https://doi.org/10.56929/jseaortho-2026-0310Keywords:
Slipped capital femoral epiphysis, in situ screw fixation, screw removal, femoral neck remodeling, radiographic outcomeAbstract
Purpose: The primary objective of this study was to investigate the remodeling process of the femoral neck after screw removal in patients with slipped capital femoral epiphysis (SCFE).
Background: In situ screw fixation is widely used to stabilize SCFE and prevent its progression, often with the expectation that physeal closure will occur over time. However, concerns remain regarding the alteration of proximal femoral growth and morphology, and the potential for remodeling after elective screw removal is not well defined.
Methods: We retrospectively reviewed 40 patients (47 hips) diagnosed with SCFE, who underwent in situ screw fixation using two cancellous screws, followed by scheduled screw removal approximately one year later. The immediate postoperative radiographs were compared with those obtained at the time of physeal closure. Radiographic parameters, including articulotrochanteric distance (ATD) and lesser trochanter–articular distance (LTA), were analyzed to assess femoral neck morphology in terms of width, length, and angular changes.
Results: Radiographic comparisons between immediate postoperative and post-physeal closure evaluations revealed a statistically significant improvements in femoral neck length, width, and anglular remodeling.
Conclusions: SCFE treated with in situ screw fixation followed by screw removal facilitates femoral neck remodeling and contributes to hip restoration at skeletal maturity.
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