Slipped capital femoral epiphysis after treatment of femoral neck fracture

Abstract

Slipped capital femoral epiphysis (SCFE) in children after treatment of femoral neck fracture is a very rare condition. This complication should be recognized promptly and treated urgently. The risk of development of this complication can be minimized by anatomical reduction of the fracture and stable internal fixation of the fracture. Five years old male child sustained right sided femur neck fracture and was treated with closed reduction and Hip spica cast application. The fracture healed with a varus deformity. After 7 months, he developed slip of femoral epiphysis with a coxa vara deformity of proximal femur, which was treated with in situ fixation with Cannulated screws. His subsequent course remained uneventful up to five months.Slipped capital femoral epiphysis (SCFE) after treatment of femoral neck fracture in children is a rare complication that should be recognized and treated promptly. The onset of SCFE may show inadequate reduction or fixation of the fracture. Anatomic reduction and stable internal fixation for femoral neck fracture in children provides best outcomes. Postoperative care and delayed weight bearing are also equally important to avoid complications.
 doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1725
 How to cite this:Chinoy MA, Pal S, Khan MA. Slipped capital femoral epiphysis after treatment of femoral neck fracture. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S94-S97. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1725
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Delayed Slipped Capital Femoral Epiphysis After Orif for Subtrochanteric Femur Fracture

“…following treatment of a proximal femoral fracture may be caused by inadequate treatment of the fracture. Orthopaedic surgeons should be aware of this unusual complication in order to promptly recognise and treat this complication [3].…”

“…Previous reports have shown that the quality of proximal femoral fracture fracture fixation and complications such as malunion, nonunion, varus deformity and and avascular necrosis may be associated with SCFE after fixation. [3][4][5][6] Ok and al. reported a case of a 6-year-old boy who developed SCFE after malunion of a subtrochanteric femoral fracture.…”

“…It is important to consider malalignment in proximal femoral fractures as a possible cause of SCFE after fixation described by Chinoy and al [3]. They described a 5-year-old case presenting with a diagnosis of SCFE following a femoral neck fracture, which was tightly reduced and fixed with a spica cast.…”

“…They described a 5-year-old case presenting with a diagnosis of SCFE following a femoral neck fracture, which was tightly reduced and fixed with a spica cast. They identified varus deformity after femoral neck fracture as a possible factor associated with SCFE [3].…”

Comparison of proximal femoral nail antirotation and total hip arthroplasty in the treatment of femoral intertrochanteric fracture

“…1,2 As conservative treatment is associated with the risk of complications such as pulmonary infection, bedsores, urinary calculi and lower extremity venous thrombosis, surgical treatment is recommended. 3,4 Proximal femoral nail antirotation (PFNA) and total hip arthroplasty are both important surgical schemes for the clinical treatment of femoral intertrochanteric fractures. PFNA fixation has the advantages of stability, compression resistance, anti-rotation and limited trauma.…”