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- Talk
- 21/02/2022
- UK
Prophylactic Pinning in Slipped Upper Femoral Epiphysis – A Closed Loop Audit of 25 Years Practice
Description
The presentation given by Ewan Semple, an orthopedic registrar from Scotland, focuses on the long-term experience with prophylactic pinning in cases of Slipped Upper Femoral Epiphysis (SUFE) over 25 years. The talk begins with an introduction to the controversial nature of prophylactic pinning, discussing the balance of risks involved in selecting patients for the procedure. Semple presents data from two cohorts: the first covering retrospective audits from 1994 to 2004, comprising 60 patients with 76 slips, and the second involving a prospective audit from 2005 to 2020, where 44 patients with 52 slips were treated.
The data indicates that while there were significant complications associated with observed patients in the first cohort (25% subsequently experiencing slips), those who underwent prophylactic pinning had minimal morbidity. Following this, a protocol for universal prophylactic pinning was established in 2005, leading to a notable decrease in complications and subsequent slips.
The presentation details complications seen in both groups, including a transient k-wire penetration and a case of premature osteoarthritis in a young female patient. Semple argues in favor of universal prophylactic pinning based on evidence from their audits, claiming it effectively reduces risks associated with contralateral slips in a setting where guidelines are limited and conflicting.
The discussion also engages audience questions about risk stratification and outcomes, emphasizing the rarity of SUFE cases and the necessary balance of treatment protocols. Overall, Semple's conclusion advocates for universal prophylactic pinning as a safe and effective practice for preventing SUFE complications.