Pin removal in slipped capital femoral epiphysis: the unsuitability of titanium devices.
In an effort to predict which slipped capital femoral epiphysis fixation devices might cause fewer retrieval problems, 27 consecutive implant-retrieval procedures were reviewed, and mechanical tests using many currently available devices were performed. Problems occurred with both stainless steel and titanium devices if implanted for > 1 year. This tendency for increased problems was statistically significant for the titanium group, and analysis of a retrieved titanium screw showed evidence of osseointegration (direct bone-metal contact at > 90% of the interface) using backscattered image scanning electron microscopic analysis. These clinical data and data from mechanical testing suggest that stainless steel screws or trocar-tipped Steinmann pins are better suited for fixation of slipped capital femoral epiphysis.
Lee
T K
TK
Harrington Arthritis Research Center, Phoenix, Arizona, USA.
Haynes
R J
RJ
Longo
J A
JA
Chu
J R
JR
D000293:Adolescent; D001858:Bone Nails / Q000009:adverse effects*; D002648:Child; D004839:Epiphyses, Slipped / Q000601:surgery*; D005270:Femur Head / Q000601:surgery*; D006801:Humans; D016014:Linear Models; D008422:Materials Testing; D015999:Multivariate Analysis; D016348:Osseointegration; D012086:Reoperation; D013193:Stainless Steel / Q000009:adverse effects*; D013314:Stress, Mechanical; D014025:Titanium / Q000009:adverse effects*
D013193:Stainless Steel; D014025:Titanium