Management of Cannulated Screw Failure and Recurrent SCFE Displacement – Case Report

Management of Cannulated Screw Failure and Recurrent SCFE Displacement – Case Report

Management of Cannulated Screw Failure and Recurrent SCFE Displacement – Case Report

Posted on Jan 8, 2014 in Jan – Mar 2014, Volume 4 Issue 1

Management of Cannulated Screw Failure and Recurrent SCFE Displacement – Case Report

What to Learn from this Article?

Surgical Technique on screw removal in case of broken screw in SCFE.


Case Report |  Volume 4 | Issue 1 | JOCR Jan-Mar 2014 | Page 28-31 | Jacobson NA, Feierabend SP, Lee CL

DOI: 10.13107/jocr.2250-0685.144


Authors: Jacobson NA[1], Feierabend SP[1], Lee CL[1]

Department of Orthopaedics, Wayne State University Orthopaedics.

Address of Correspondence:

Dr Nathan A.
Jacobson M.D., Wayne State University Orthopaedics, 10000 Telegraph
Road, Taylor, MI 48124. Email: njacobso@med.wayne.edu. Phone:
661-428-8567 / Fax: 313-3757226.


Abstract

Introduction: SCFE
occurs in 10 per 100,000 in some regions of the United States with the
incidence continuing to increase. Percutaneous screw fixation is a
well-accepted treatment for this disorder for over 20 years but
management of complications is not well elucidated in the literature.

Case Report: We
describe a case where a traumatic unstable SCFE that was initially
treated with closed reduction and fixation with a single transphyseal
screw went on to hardware failure with recurrence of the deformity. The
complication was successfully treated with closed reduction and re-
cannulating the fractured screw within the epiphysis and extracting it
using a conical extraction screw commonly referred to as an “easy out.”
 Three trans physeal screws were then placed for improved fixation
strength.  Follow-up at 9 months demonstrates a fused physis and no
signs of avascular necrosis of the femoral head.

Conclusion: Percutaneous
management of SCFE screw breakage is possible utilizing specialized
instruments and a precise and gentle manipulation preventing the need
for more invasive treatments with their obligatory potential
complications profile.

Keywords: Hardware Failure, Slip Recurrence, SCFE, Complication, Conical Extraction Screw, Easy Out.

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