In situ fixation with a single screw is the treatment of choice for mild to moderate slipped capital femoral epiphysis and has been reported as relatively complication-free. The complications that do occur tend to be related to screw insertion, with joint penetration, and on screw removal, when fracture of the screw may occur. The authors report a unique case of in situ failure of the single cannulated screw leading to progression of the slip. This may have been related to screw design, and the treatment options and complications of screw fixation in slipped capital femoral epiphysis are discussed.
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2.
KovalK.J., LehmanW.B., RoseD., KovalR.P., GrantA., Strong-waterA.. Treatment of slipped capital femoral epiphysis with a cannulated-screw technique. J Bone Joint Surg1989; 71-A: 1370–7.
3.
De SanctisN., Di GennaroG., PempinelloC., Della CorteS., CarannanteG.. Is gentle manipulative reduction and percutaneous fixation with a single screw the best management of acute and acute-on-chronic slipped capital femoral epiphysis? A report of 70 patients. J Pediatr Orthop Belg1996; 5: 90–5.
4.
RileyP.M., WeinerD.S., GillespieR., WeinerS.D.. Hazards of internal fixation in the treatment of slipped capital femoral epiphysis. J Bone Joint Surg1990; 72-A: 1500–9.
5.
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6.
CanaleS.T., AzarF., YoungJ., BeatyJ.H., WarnerW.C., WhitmerG.. Subtrochanteric fracture after fixation of slipped capital femoral epiphysis: A complication of unused drill holes. J Pediatr Orthop Belg1994; 14: 623–6.
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LubickyJ.P.. Chondrolysis and avascular necrosis: Complications of slipped capital femoral epiphysis. J Pediatr Orthop Belg1996; 5: 162–7.
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MorrissyR.T.. Slipped capital femoral epiphysis: technique of percutaneous in situ fixation. J Pediatr Orthop Belg1990; 10: 347–50.
9.
NguyenD., MorrissyR.T.. Slipped capital femoral epiphysis: Rationale for the technique of percuatneous in situ fixation. J Pediatr Orthop Belg1990; 10: 341–6.
10.
CrawfordA.H.. Slipped capital femoral epiphysis. J Bone Joint Surg1988; 70-A: 1422–7.
11.
LeeT.K., HaynesR.J., LongoJ.A., ChuJ.R.. Pin removal in slipped capital femoral epiphysis: The unsuitability of titanium devices. J Pediatr Orthop Belg1996; 16: 49–52.
12.
KibiloskiL.J., DoaneR.M., KarolL.A., HautR.G., LoderR.T.. Biomechanical analysis of single- versus double-screw fixation in slipped capital femoral epiphysis at physiological load levels. J Pediatr Orthop Belg1994; 14: 627–30.
