Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports

Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to preve...
Ausführliche Beschreibung

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Autor*in:	Engelsma, Yde [verfasserIn] Morgenstern, Paul Van Der Sluijs, Hans A Witbreuk, Melinda M

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2012

Schlagwörter:	Growth Plate Screw Fixation Slip Capital Femoral Epiphysis Open Growth Plate Slip Epiphysis

Anmerkung:	© Engelsma et al.; licensee BioMed Central Ltd. 2012

Übergeordnetes Werk:	Enthalten in: Journal of medical case reports - London : BioMed Central, 2007, 6(2012), 1 vom: 26. Nov.
Übergeordnetes Werk:	volume:6 ; year:2012 ; number:1 ; day:26 ; month:11

Links:	Volltext

DOI / URN:	10.1186/1752-1947-6-405

Katalog-ID:	SPR031049311

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520			\|a Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate.
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allfields	10.1186/1752-1947-6-405 doi (DE-627)SPR031049311 (SPR)1752-1947-6-405-e DE-627 ger DE-627 rakwb eng Engelsma, Yde verfasserin aut Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Engelsma et al.; licensee BioMed Central Ltd. 2012 Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate. Growth Plate (dpeaa)DE-He213 Screw Fixation (dpeaa)DE-He213 Slip Capital Femoral Epiphysis (dpeaa)DE-He213 Open Growth Plate (dpeaa)DE-He213 Slip Epiphysis (dpeaa)DE-He213 Morgenstern, Paul aut Van Der Sluijs, Hans A aut Witbreuk, Melinda M aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 6(2012), 1 vom: 26. Nov. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:6 year:2012 number:1 day:26 month:11 https://dx.doi.org/10.1186/1752-1947-6-405 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2012 1 26 11
spelling	10.1186/1752-1947-6-405 doi (DE-627)SPR031049311 (SPR)1752-1947-6-405-e DE-627 ger DE-627 rakwb eng Engelsma, Yde verfasserin aut Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Engelsma et al.; licensee BioMed Central Ltd. 2012 Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate. Growth Plate (dpeaa)DE-He213 Screw Fixation (dpeaa)DE-He213 Slip Capital Femoral Epiphysis (dpeaa)DE-He213 Open Growth Plate (dpeaa)DE-He213 Slip Epiphysis (dpeaa)DE-He213 Morgenstern, Paul aut Van Der Sluijs, Hans A aut Witbreuk, Melinda M aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 6(2012), 1 vom: 26. Nov. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:6 year:2012 number:1 day:26 month:11 https://dx.doi.org/10.1186/1752-1947-6-405 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2012 1 26 11
allfields_unstemmed	10.1186/1752-1947-6-405 doi (DE-627)SPR031049311 (SPR)1752-1947-6-405-e DE-627 ger DE-627 rakwb eng Engelsma, Yde verfasserin aut Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Engelsma et al.; licensee BioMed Central Ltd. 2012 Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate. Growth Plate (dpeaa)DE-He213 Screw Fixation (dpeaa)DE-He213 Slip Capital Femoral Epiphysis (dpeaa)DE-He213 Open Growth Plate (dpeaa)DE-He213 Slip Epiphysis (dpeaa)DE-He213 Morgenstern, Paul aut Van Der Sluijs, Hans A aut Witbreuk, Melinda M aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 6(2012), 1 vom: 26. Nov. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:6 year:2012 number:1 day:26 month:11 https://dx.doi.org/10.1186/1752-1947-6-405 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2012 1 26 11
allfieldsGer	10.1186/1752-1947-6-405 doi (DE-627)SPR031049311 (SPR)1752-1947-6-405-e DE-627 ger DE-627 rakwb eng Engelsma, Yde verfasserin aut Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Engelsma et al.; licensee BioMed Central Ltd. 2012 Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate. Growth Plate (dpeaa)DE-He213 Screw Fixation (dpeaa)DE-He213 Slip Capital Femoral Epiphysis (dpeaa)DE-He213 Open Growth Plate (dpeaa)DE-He213 Slip Epiphysis (dpeaa)DE-He213 Morgenstern, Paul aut Van Der Sluijs, Hans A aut Witbreuk, Melinda M aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 6(2012), 1 vom: 26. Nov. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:6 year:2012 number:1 day:26 month:11 https://dx.doi.org/10.1186/1752-1947-6-405 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2012 1 26 11
allfieldsSound	10.1186/1752-1947-6-405 doi (DE-627)SPR031049311 (SPR)1752-1947-6-405-e DE-627 ger DE-627 rakwb eng Engelsma, Yde verfasserin aut Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Engelsma et al.; licensee BioMed Central Ltd. 2012 Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate. Growth Plate (dpeaa)DE-He213 Screw Fixation (dpeaa)DE-He213 Slip Capital Femoral Epiphysis (dpeaa)DE-He213 Open Growth Plate (dpeaa)DE-He213 Slip Epiphysis (dpeaa)DE-He213 Morgenstern, Paul aut Van Der Sluijs, Hans A aut Witbreuk, Melinda M aut Enthalten in Journal of medical case reports London : BioMed Central, 2007 6(2012), 1 vom: 26. Nov. (DE-627)524231389 (DE-600)2269805-X 1752-1947 nnns volume:6 year:2012 number:1 day:26 month:11 https://dx.doi.org/10.1186/1752-1947-6-405 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2012 1 26 11
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Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. 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author	Engelsma, Yde
spellingShingle	Engelsma, Yde misc Growth Plate misc Screw Fixation misc Slip Capital Femoral Epiphysis misc Open Growth Plate misc Slip Epiphysis Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports
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topic_title	Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports Growth Plate (dpeaa)DE-He213 Screw Fixation (dpeaa)DE-He213 Slip Capital Femoral Epiphysis (dpeaa)DE-He213 Open Growth Plate (dpeaa)DE-He213 Slip Epiphysis (dpeaa)DE-He213
topic	misc Growth Plate misc Screw Fixation misc Slip Capital Femoral Epiphysis misc Open Growth Plate misc Slip Epiphysis
topic_unstemmed	misc Growth Plate misc Screw Fixation misc Slip Capital Femoral Epiphysis misc Open Growth Plate misc Slip Epiphysis
topic_browse	misc Growth Plate misc Screw Fixation misc Slip Capital Femoral Epiphysis misc Open Growth Plate misc Slip Epiphysis
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title	Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports
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title_full	Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports
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author_browse	Engelsma, Yde Morgenstern, Paul Van Der Sluijs, Hans A Witbreuk, Melinda M
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title_sort	progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports
title_auth	Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports
abstract	Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate. © Engelsma et al.; licensee BioMed Central Ltd. 2012
abstractGer	Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate. © Engelsma et al.; licensee BioMed Central Ltd. 2012
abstract_unstemmed	Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate. © Engelsma et al.; licensee BioMed Central Ltd. 2012
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title_short	Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports
url	https://dx.doi.org/10.1186/1752-1947-6-405
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author2	Morgenstern, Paul Van Der Sluijs, Hans A Witbreuk, Melinda M
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up_date	2024-07-03T21:41:21.237Z
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Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports

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