Biomechanical Comparison of Perpendicular Versus Oblique In Situ Screw Fixation of Slipped Capital Femoral Epiphysis

  title={Biomechanical Comparison of Perpendicular Versus Oblique In Situ Screw Fixation of Slipped Capital Femoral Epiphysis},
  author={Michael K. Merz and Farid Amirouche and Giovanni F. Solitro and Jeffrey A. Silverstein and Tyler Surma and Prasad V Gourineni},
  journal={Journal of Pediatric Orthopaedics},
Background: Percutaneous in situ single screw fixation is the preferred treatment for stable and unstable slipped capital femoral epiphysis (SCFE). The recommended screw placement is in the center of the epiphysis and perpendicular to the physis, which necessitates an anterior starting point for most SCFEs. A recent clinical study has shown good clinical results with a laterally based screw for SCFE, which is oblique to the physis. We sought to biomechanically compare these 2 techniques for… Expand
3 Citations
The Universal Entry Point with oblique screw is superior to fixation perpendicular to the physis in moderate slipped capital femoral epiphysis
This study model the biomechanical effect of two screw positions used for SCFE fixation and 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 screws fixation perpendicular to the physis. Expand
The point of epiphyseal penetration affects rotational stability of screw fixation in slipped capital femoral epiphysis: A biomechanical study
  • W. Morris, A. Riccio, +5 authors E. Novais
  • Medicine
  • Journal of orthopaedic research : official publication of the Orthopaedic Research Society
  • 2020
In a biomechanical model of single screw fixation of stable SCFE, a screw passing through the epiphyseal tubercle (the axis of rotation) would confer less rotational stability than a centrally placed screw and screw position through the tubercle was associated with equal or greater rotational stiffness and maximum torque during displacement as a centrallyplaced screw. Expand
Slipped Capital Femoral Epiphysis : Pathogenetic and Clinical aspects
Melinda Witbreuk Kroezeboom A Kroezeboom is a tree, usually an oak, which indicates a boundary or junction. In the east of the Netherlands stones or trees were often used as boundary determination ofExpand


Oblique In Situ Screw Fixation of Stable Slipped Capital Femoral Epiphysis
Oblique placement of the screw for in situ fixation in stable slipped capital femoral epiphysis did not cause any deleterious effects and offered several potential advantages. Expand
Biomechanical Comparison of Fully and Partially Threaded Screws for Fixation of Slipped Capital Femoral Epiphysis
Although there were no differences between screw types in an in vitro model, bone healing around the fully threaded screw may eventually provide greater stability, and implant removal may be easier with such a system. Expand
Screw Head Impingement After In Situ Fixation in Moderate and Severe Slipped Capital Femoral Epiphysis
Alternative in situ fixation techniques (screw head resting lateral to the intertrochanteric line on the anteroposterior radiograph) may decrease the rate of screw head impingement in moderate and severe SCFEs. Expand
Biomechanical Analysis of Compression Screw Fixation Versus Standard In Situ Pinning in Slipped Capital Femoral Epiphysis
Single-screw compression fixation of in vitro bovine femora was significantly more stiff than the current, widely used noncompression fixation technique, yet does not compromise the ultimate strength, energy absorbed, or the technical ease of single-implant fixation. Expand
Biomechanical Analysis of In Situ Single Versus Double Screw Fixation in a Nonreduced Slipped Capital Femoral Epiphysis Model
The increased rotational stability of double-screw fixation under torsional loading conditions may justify its use in in situ stabilization of acute or unstable SCFE. Expand
Biomechanical Stability of Single-screw Versus Two-screw Fixation of an Unstable Slipped Capital Femoral Epiphysis Model: Effect of Screw Position in the Femoral Neck
Data support the use of a 2 screw construct in acute/unstable SCFE fixation and the biomechanical benefit of 2 screws needs to be considered in the face of greater potential for inadvertent penetration into the joint with an increased number of screws. Expand
Biomechanical Analysis of Single Screw Fixation for Slipped Capital Femoral Epiphysis: Are More Threads Across the Physis Necessary for Stability?
This study challenges the belief that compression across the physis maximizes slipped capital femoral epiphysis fixation stability and recommends equal distribution of threads across the physiis when using 16-mm thread screws, and postulate that screws with a greater thread length would increase fixation stability even further. Expand
Fixation with a single screw for slipped capital femoral epiphysis.
fixation with a single 6.5 or sevenmillimeter-diameter screw provided adequate epiphyseal stability and promoted premature physeal fusion in patients, while decreasing the rate of complications compared with that reported to be associated with fixation with multiple screws or pins. Expand
Slip Progression After In Situ Single Screw Fixation for Stable Slipped Capital Femoral Epiphysis
The medical records and frog-leg lateral radiographs of 37 children with 46 stable slips treated with in situ single cannulated screw fixation at the Shriners Hospitals for Children, Lexington, from 1990 to 1998 were reviewed and screw advancement until five threads engage the epiphysis appears appropriate. Expand
Torsional Strength of Double- Versus Single-screw Fixation in a Pig Model of Unstable Slipped Capital Femoral Epiphysis
Slipped capital femoral epiphysis was produced in 9 matched pairs of fresh-frozen pig femurs by twisting the femoral head about the Femoral neck axis by using a single steel cannulated screw on one side and 2 screws contralaterally, after which the perichondrium was removed before retesting. Expand