Journal article
Biomechanical Study of 16-mm Threaded, 32-mm Threaded, and Fully Threaded SCFE Screw Fixation
Journal of pediatric orthopaedics, Vol.32(1), pp.70-74
2012
DOI: 10.1097/BPO.0b013e31823b18dd
PMID: 22173391
Abstract
Background:
The initial goals of the treatment of slipped capital femoral epiphysis (SCFE) are to stabilize the epiphysis, prevent slip progression, and avoid complications. In situ fixation with a single screw is the most accepted procedure to provide an optimal fixation, but fixation failure and slip progression suggest that the procedure might be improved. The aim of the present study was to biomechanically compare partially threaded screws (16 mm and 32 mm) and fully threaded screws in an in vitro porcine model.
Methods:
An unstable/acute SCFE was created in 18 skeletally immature porcine femurs through a type 1 Salter-Harris fracture. Each femur was fixed using a 6.5-mm stainless-steel cannulated screw inserted through the physis under fluoroscopic guidance. The screw was either 16 mm threaded, 32 mm threaded, or fully threaded (n=6 each group). Each specimen was cyclically tested to failure fixation by anterior-to-posterior loading through the femoral head.
Results:
No significant difference was detected between the Newton cycles to failure of the 3 screw-thread groups. The 16-mm threaded group had the highest frequency of femoral neck failure.
Conclusions:
The 16-mm threaded screws had the highest rate of neck failure and did not demonstrate additional fixation stability over the 32-mm threaded and fully threaded screws. As femoral neck fracture is a rare but devastating complication in pediatric patients, clinical use of the 32-mm threaded and fully threaded screws may be indicated in SCFE fixation.
Clinical Relevance:
The use of 32-mm or fully threaded screws is a valid SCFE treatment option. The increased number of threads in the metaphysis with these screws may confer additional biomechanical strength to the femoral neck.
Details
- Title: Subtitle
- Biomechanical Study of 16-mm Threaded, 32-mm Threaded, and Fully Threaded SCFE Screw Fixation
- Creators
- Massimiliano DRAGONI - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, United StatesAnneliese Dorothy Heiner - Biomechanics Laboratory, University of Iowa, Iowa City, IA, United StatesSimone COSTA - Ospedale San Giovanni Calibita Fatebenefratelli, ItalyArmando GABRIELLI - Policlinico Casilino, UOC Orthopaedics and Traumatology, Rome, ItalyStuart L WEINSTEIN - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, United States
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric orthopaedics, Vol.32(1), pp.70-74
- Publisher
- Lippincott Williams & Wilkins; Hagerstown, MD
- DOI
- 10.1097/BPO.0b013e31823b18dd
- PMID
- 22173391
- ISSN
- 0271-6798
- eISSN
- 1539-2570
- Language
- English
- Date published
- 2012
- Academic Unit
- Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
- Record Identifier
- 9984040571002771
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