Dual Small-Diameter Screw Fixation in Acute Traumatic Slipped Capital Femoral Epiphysis A Case Report
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Abstract
Slipped capital femoral epiphysis (SCFE) is typically a chronic condition associated with metabolic and biomechanical factors, whereas acute traumatic SCFE in a previously asymptomatic adolescent is uncommon and carries a higher risk of avascular necrosis (AVN). We report the case of a 15-year-old male who presented with acute right hip pain and inability to bear weight following high-energy trauma. Radiographs demonstrated an unstable SCFE with severe displacement and no radiographic features of chronicity. The patient underwent urgent closed reduction and percutaneous fixation using two 4.0 mm cannulated screws, consisting of one partially threaded and one fully threaded screw. Postoperatively, he was managed with staged non-weight-bearing followed by gradual return to full weight-bearing. At 12 months, the patient was asymptomatic with no radiological evidence of AVN or loss of reduction. Functional outcome assessment demonstrated excellent recovery, with a Non-Arthritic Hip Score of 97.5% and high Hip disability and Osteoarthritis Outcome Score values across domains, including pain (98.6), symptoms (98.5), activities of daily living (100), sports and recreation (93.75), and quality of life (100). This case shows a favorable short-term outcome following dual small-diameter screw fixation; however, given the single-case design and limited follow-up, no conclusions regarding implant superiority or reduction in AVN risk can be drawn. Further studies are required to evaluate this technique in unstable SCFE.
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References
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