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.


 

How to Cite This Article: Jacobson NA, Feierabend SP, Lee CL. Management of Cannulated Screw Failure and Recurrent SCFE Displacement – Case Report. Journal of Orthopaedic Case Reports 2014 Jan-Mar ;4(1): 28-31. Available from: http://www.jocr.co.in/wp/2014/01/08/2250-0685-144-fulltext/


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