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Jacobson NA, Feierabend SP, Lee CL. Management of Cannulated Screw Failure and Recurrent SCFE Displacement - Case Report. J Orthop Case Rep. 2014;4(1):28-31doi: 10.13107/jocr.2250-0685.144.
Jacobson, N. A., Feierabend, S. P., & Lee, C. L. (2014). Management of Cannulated Screw Failure and Recurrent SCFE Displacement - Case Report. Journal of orthopaedic case reports, 4(1), 28-31. https://doi.org/10.13107/jocr.2250-0685.144
Jacobson, Nathan A, et al. "Management of Cannulated Screw Failure and Recurrent SCFE Displacement - Case Report." Journal of orthopaedic case reports vol. 4,1 (2014): 28-31. doi: https://doi.org/10.13107/jocr.2250-0685.144
Jacobson NA, Feierabend SP, Lee CL. Management of Cannulated Screw Failure and Recurrent SCFE Displacement - Case Report. J Orthop Case Rep. 2014 Jan-Mar;4(1):28-31. doi: 10.13107/jocr.2250-0685.144. PMID: 27298941; PMCID: PMC4722563.
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J Orthop Case Rep. 2014 Jan-Mar;4(1):28-31. doi: 10.13107/jocr.2250-0685.144.

Management of Cannulated Screw Failure and Recurrent SCFE Displacement - Case Report.

Journal of orthopaedic case reports

Nathan A Jacobson, Siegfried P Feierabend, Christopher L Lee

Affiliations

  1. Department of Orthopaedics Wayne State University Orthopaedics.

PMID: 27298941 PMCID: PMC4722563 DOI: 10.13107/jocr.2250-0685.144

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: Complication; Conical Extraction Screw; Easy Out; Hardware Failure; SCFE; Slip Recurrence

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