Displaced Femoral Neck Fractures at the Bone-Screw Interface After In Situ Fixation of Slipped Capital Femoral Epiphysis

Canale, S. Terry; Casillas, Mark M.; Jv, Banta

doi:10.1097/00004694-199703000-00014

Cited by 21 publications

(4 citation statements)

References 9 publications

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“…Cases of chondrolysis after the placement of implants for periarticular soft-tissue or fracture fixation, a history of joint trauma, and surgical insult with or without improper techniques have been reported across all joints [1][2][3]13,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][31][32][33][34][35][45][46][47][48]51,[53][54][55][56][57][58][59][60][61][63][64][65][66]69,70,[72][73][74][75][76][77][78][79]…”

Section: Potential Etiologic Contributors To Joint Chondrolysismentioning

confidence: 99%

Joint Chondrolysis

Provencher¹,

Navaie²,

Solomon³

et al. 2011

The Journal of Bone and Joint Surgery-American Volume

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Although the disease was first described in the hip, reports of chondrolysis in nearly all diarthrodial joints have since emerged with considerable variations in the literature.Despite speculation among clinicians and researchers about the implicit causal pathways and etiologic contributors associated with chondrolysis, definitive answers remain elusive.The term chondrolysis has been applied to varied levels of joint cartilage destruction from focal chondral defects to diffuse cartilage loss, revealing a lack of consistency in the application of diagnostic criteria to guide differential disease classification.Differentiating between the various potential etiologies associated with chondrolysis provides opportunities for the prevention of the disease.

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Section: Potential Etiologic Contributors To Joint Chondrolysismentioning

confidence: 99%

Joint Chondrolysis

Provencher¹,

Navaie²,

Solomon³

et al. 2011

The Journal of Bone and Joint Surgery-American Volume

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“…This has the additional benefit of reducing the risk of fracture, which has been described with both anterior and lateral starting points. [19][20][21] Thus, the UEP is named universal as it can be utilized in all in situ SCFE fixation. If in pre-operative planning a screw from the UEP will penetrate the posterior cortex, then a surgeon may wish to consider whether in situ fixation is appropriate.…”

Section: Discussionmentioning

confidence: 99%

The Universal Entry Point with oblique screw is superior to fixation perpendicular to the physis in moderate slipped capital femoral epiphysis

Lee

Lillia

Bellemore

et al. 2020

Journal of Children's Orthopaedics

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Purpose Stable slipped capital femoral epiphysis (SCFE) is often treated with in situ pinning, with the current gold standard being stabilization with a screw perpendicular to the physis. However, this can lead to impingement and a potentially unstable construct. In this study we model the biomechanical effect of two screw positions used for SCFE fixation. We hypothesize that single screw fixation into the centre of the femoral head from the anterior intertrochanteric line (the Universal Entry Point or UEP) provides a more stable construct than single screw fixation perpendicular to the physis with an anterior starting point. Methods Sawbone models of moderate SCFE were used to mechanically test the two screw constructs and an unfixed control group. Models were loaded to failure with a shear load applied through the physis in an Instron mechanical tester. The primary outcomes were maximum load, stiffness and energy to failure. Results Screw fixation into the centre of the femoral head from the UEP resulted in a greater load to failure (+19%), stiffness (+13%) and energy to failure (+45%) than screw fixation perpendicular to the physis. Conclusions In this sawbone construct, screw fixation into the centre of the femoral head from the UEP provides greater biomechanical stability than screw fixation perpendicular to the physis. This approach may also benefit by avoiding an intracapsular entry point in soft metaphyseal bone and subsequent risk of impingement and loss of position.

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“…A study by Canale et al documented two cases of displaced femoral neck fractures at what they call the “bone-screw interface” [9]. They documented one case in which the fracture was treated by cannulated screws and Knowles pins and another case treated with a sliding hip screw.…”

Section: Discussionmentioning

confidence: 99%

Subtrochanteric Femur Fracture after Slipped Capital Femoral Epiphysis Pinning: A Novel Treatment

Paloski

Taylor

Willits

2011

Advances in Orthopedics

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Slipped capital femoral epiphysis is a common injury suffered by adolescents worldwide. Treatment of most slips can be accomplished by percutaneous screw fixation, as this is an accepted and proven method associated with minimal morbidity. Complications, although limited, can be problematic for both the patient and treating physician. These include avascular necrosis, chondrolysis, infection, and fracture. We report a case of an individual who sustained a subtrochanteric femure fracture three weeks after in situ pinning of his left hip treated with a reconstruction intramedullary nail. This option allowed both the subtrochanteric fracture and SCFE to be treated concomitantly with minimized morbidity.

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Displaced Femoral Neck Fractures at the Bone-Screw Interface After In Situ Fixation of Slipped Capital Femoral Epiphysis

Cited by 21 publications

References 9 publications

Joint Chondrolysis

Joint Chondrolysis

The Universal Entry Point with oblique screw is superior to fixation perpendicular to the physis in moderate slipped capital femoral epiphysis

Subtrochanteric Femur Fracture after Slipped Capital Femoral Epiphysis Pinning: A Novel Treatment

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