Radiation exposure during in-situ pinning of slipped capital femoral epiphysis hips: does the patient positioning matter?

Multiple radiographic images may be necessary during the standard procedure of in-situ pinning of slipped capital femoral epiphysis (SCFE) hips. This procedure can be performed with the patient positioned on a fracture table or a radiolucent table. Our study aims to look at any differences in the amount and duration of radiation exposure for in-situ pinning of SCFE performed using a traction table or a radiolucent table. Sixteen hips in thirteen patients who were pinned on radiolucent table were compared for the cumulative radiation exposure to 35 hips pinned on a fracture table in 33 patients during the same time period. Cumulative radiation dose was measured as dose area product in Gray centimeter2 and the duration of exposure was measured in minutes. Appropriate statistical tests were used to test the significance of any differences. Mean cumulative radiation dose for SCFE pinned on radiolucent table was statistically less than for those pinned on fracture table (P<0.05). The mean duration of radiation exposure on either table was not significantly different. Lateral projections may increase the radiation doses compared with anteroposterior projections because of the higher exposure parameters needed for side imaging. Our results showing decreased exposure doses on the radiolucent table are probably because of the ease of a frog leg lateral positioning obtained and thereby the ease of lateral imaging. In-situ pinning of SCFE hips on a radiolucent table has an additional advantage that the radiation dose during the procedure is significantly less than that of the procedure that is performed on a fracture table.