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

Paloski, Michael; Taylor, Benjamin C.; Willits, Mark

doi:10.4061/2011/809136

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…1 Some case examples from the literature include a post-traumatic subtrochanteric fracture resulting from a cycling accident that followed in situ pinning of a mild SCFE with cannulated screw fixation. 18 The child required screw removal and insertion of a cephalomedullary device to fix the fracture.…”

Section: Subtrochanteric Fracturesmentioning

confidence: 99%

Hardware Complications Related to the Surgical Fixation of Slipped Capital Femoral Epiphyses

Massa

Silk

Heidari

et al. 2014

J Long Term Eff Med Implants

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Slipped upper femoral epiphysis is a disabling condition with an annual incidence of 2-13 per 100,000. In situ surgical fixation is the preferred initial treatment for both stable and unstable slipped capital femoral epiphysis (SCFE) cases. The main aim is to avoid further slippage and complications such as osteonecrosis and chondrolysis. The choice of medical implants in managing this condition has changed along the years from large nail-like devices to cannulated screws. The biomechanical properties of different fixation techniques have been studied. All implants have been associated with complications that can occur intraoperatively as well as in the early and late postoperative periods. This report examines a number of different implants used and identifies complications and ways on how to avoid such complications. It also looks at the complications directly related to medical implants in the management of SCFE. We looked at published literature in peer-reviewed journals describing the use of the different medical implants and the documented complications. We also examined literature that suggests ways on how to avoid and manage these complications. A review of the current literature is presented in this text.

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Section: Subtrochanteric Fracturesmentioning

confidence: 99%

Hardware Complications Related to the Surgical Fixation of Slipped Capital Femoral Epiphyses

Massa

Silk

Heidari

et al. 2014

J Long Term Eff Med Implants

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show abstract

“…Any interference that affects the integrity of the lateral cortex increases the stress levels within this region; therefore, cannulated screws applied to FNFs, pins applied to the slipped capital femoral epiphysis, core decompression applied to the femoral head avascular necrosis, or unused pin and screw holes could lead to fatigue fractures within this region during postoperative care. 8,10,12–16…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis of the impact of screw insertion distal to the trochanter minor on the risk of iatrogenic subtrochanteric fracture

Şensöz

Özkal

Acar

et al. 2018

Proc Inst Mech Eng H

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Iatrogenic subtrochanteric fractures are rarely encountered after cannulated screw fixation of femoral neck fractures; however, when they do occur, there can be several complications. Many orthopedic surgeons have concerns about the potential for iatrogenic subtrochanteric fractures after screw fixation distal to the trochanter minor; therefore, some surgeons are typically reluctant to perform this procedure. This study focused on the risk of an iatrogenic subtrochanteric fracture after treating femoral neck fractures with cannulated screws. The main purpose of the study was to understand iatrogenic subtrochanteric fractures and evaluate the effects on these fractures of an inverted triangular-shaped configuration for placement of the cannulated screws. A femur bone with an femoral neck fracture at a 40° incline to the horizontal plane was generated along with a representation of a three-dimensional finite element model, and three inverted triangular-shaped configurations for placement of the cannulated screws were investigated using finite element analyses. Statistical results indicated that the occurrence risk of ISF increases when the screw is located distal to the trochanter minor. Moreover, the risk of occurrence of intertrochanteric fracture increases when the screw is located medial to the trochanter minor because of local concentrated stress on the surface of the screw canals. To avoid the vulnerability of the subtrochanteric region, it was found that proximal placement of the screws using the inverted triangular-shaped configuration could yield better results. In addition, the results of this study provide suggestions on improved screw configurations.

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Should cannulated screws be removed after a femoral neck fracture has healed, and how? A finite element analysis of the femur before and after cannulated screw removal

Sun

Fang

et al. 2022

International Orthopaedics (SICOT)

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

Cited by 3 publications

References 14 publications

Hardware Complications Related to the Surgical Fixation of Slipped Capital Femoral Epiphyses

Hardware Complications Related to the Surgical Fixation of Slipped Capital Femoral Epiphyses

Finite element analysis of the impact of screw insertion distal to the trochanter minor on the risk of iatrogenic subtrochanteric fracture

Should cannulated screws be removed after a femoral neck fracture has healed, and how? A finite element analysis of the femur before and after cannulated screw removal

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