{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T04:52:11Z","timestamp":1740113531065,"version":"3.37.3"},"reference-count":20,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T00:00:00Z","timestamp":1590105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>The epiphyseal tubercle, a posterosuperior projection of the epiphysis into the metaphysis, serves as the axis of rotation in slipped capital femoral epiphysis (SCFE) and a source of physeal stability. We hypothesized that in a biomechanical model of single screw fixation of stable SCFE, a screw passing through the epiphyseal tubercle (the axis of rotation) would confer less rotational stability than a centrally placed screw. Three femurs were selected from a sample population of 8\u2010 to 15\u2010year\u2010old healthy hips to represent three stages of maturation: a \u201cyoung\u201d femur with a prominent epiphyseal tubercle and decreased epiphyseal cupping around the metaphysis, a \u201cmedian\u201d femur with a subsiding tubercle, and a \u201cmature\u201d femur with a subsided epiphyseal tubercle and increased peripheral epiphyseal cupping. Specimens were three\u2010dimensional printed with one of two screw trajectories: passing centrally in the epiphysis or directly through the epiphyseal tubercle. Resistance to rotational displacement was measured through stiffness and maximum torque over 30\u00b0 degrees of displacement. In the \u201cyoung\u201d model, epiphyseal tubercle screw position conferred less rotational stiffness and required less maximum torque during rotational displacement when compared to a centrally placed screw (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). In the \u201cmedian\u201d and \u201cmature\u201d models where the tubercle has subsided and is replaced by peripheral epiphyseal cupping, screw position through the tubercle was associated with equal or greater rotational stiffness and maximum torque during displacement as a centrally placed screw.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jor.24747","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T21:17:36Z","timestamp":1589923056000},"page":"2634-2639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The point of epiphyseal penetration affects rotational stability of screw fixation in slipped capital femoral epiphysis: A biomechanical study"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9743-6756","authenticated-orcid":false,"given":"William Z.","family":"Morris","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Texas Scottish Rite Hospital for Children Dallas Texas"},{"name":"Department of\u00a0Orthopedic Surgery University of Texas, Southwestern Medical Center Dallas Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony I.","family":"Riccio","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Texas Scottish Rite Hospital for Children Dallas Texas"},{"name":"Department of\u00a0Orthopedic Surgery University of Texas, Southwestern Medical Center Dallas Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Podeszwa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Texas Scottish Rite Hospital for Children Dallas Texas"},{"name":"Department of\u00a0Orthopedic Surgery University of Texas, Southwestern Medical Center Dallas Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Texas Scottish Rite Hospital for Children Dallas Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen D.","family":"Standefer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Texas Scottish Rite Hospital for Children Dallas Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7742-5769","authenticated-orcid":false,"given":"Ata","family":"Kiapour","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Boston Children's Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond W.","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Surgery Rainbow Babies and Children's Hospital Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9187-3100","authenticated-orcid":false,"given":"Eduardo N.","family":"Novais","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Boston Children's Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.89B10.19563"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453670903153550"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.00474"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000438"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.01028"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967118781579"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.24278"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000881"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.18.00440"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0b013e328364eb74"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199274060-00001"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199303000-00014"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199274060-00002"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200203000-00022"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-15-317"},{"key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1097\/BPO.0000000000000379","article-title":"Biomechanical 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