Hardware complications related to the surgical fixation of slipped capital femoral epiphyses

J Long Term Eff Med Implants. 2014;24(2-3):163-71. doi: 10.1615/jlongtermeffmedimplants.2014010926.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Cartilage Diseases / etiology
  • Cartilage Diseases / prevention & control
  • Femoral Fractures / etiology
  • Femoral Fractures / prevention & control
  • Humans
  • Internal Fixators / adverse effects
  • Intraoperative Complications / prevention & control
  • Orthopedic Fixation Devices / adverse effects*
  • Osteolysis / etiology
  • Osteolysis / prevention & control
  • Postoperative Complications / prevention & control
  • Slipped Capital Femoral Epiphyses / surgery*