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


METHODS
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.


CONCLUSIONS
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.
Department of Orthopaedics Wayne State University Orthopaedics.
Nathan A
NA
Jacobson
Department of Orthopaedics Wayne State University Orthopaedics.
Siegfried P
SP
Feierabend
Department of Orthopaedics Wayne State University Orthopaedics.
Christopher L
CL
Lee
Complication; Conical Extraction Screw; Easy Out; Hardware Failure; SCFE; Slip Recurrence