PMC4722563_01
Initial Anterior-Posterior (A) and Lateral (B) Post-operative x-rays demonstrating proper center-center position of the transphyseal screw and minimal SCFE displacement. Anterior-Posterior (C) and Lateral (D) x-ray demonstrating hardware failure and progression of the SCFE.
JOCR-4-28-g001.jpg
PMC4722563_01_JOCR-4-28-g001.jpg
F1
The procedure was uncomplicated with appropriate center-center positioning of the screw within the head and epiphysis [Fig 1a and b]. New X-rays were obtained that demonstrated failure of the hardware with progression of the SCFE displacement, with a Grade 3 slip angle measured at 60 degrees [Fig 1 c and d].
(A) Conical Extraction Screw / Easy Out. (B) Standard screws advance with clockwise rotation so having the Conical Extraction Screw / Easy Out reverse threaded advancement is with a counter-clockwise motion and as it grips the fractured screw fragment it will reverse or back out the standard clockwise threaded screw fragment.
JOCR-4-28-g003.jpg
PMC4722563_01_JOCR-4-28-g003.jpg
F3
A cannulated Conical Extraction Screw (Synthes (r) Screw Extraction Set) commonly referred to as an "Easy Out" device (Fig 3) was then inserted over the guide-wire into the fractured distal screw fragment within the epiphysis through tract left after the removal of the proximal screw fragment.