Impact of Screw Type on Torque During Slipped Capital Femoral Epiphysis Screw Removal
Slipped Capital Femoral Epiphysis (SCFE) is a disorder that occurs in adolescents in which the femoral head slips with respect to the femoral neck. SCFE can lead to abnormal hip mechanics which may result in the need for realignment of the femoral head through surgery. Percutaneous in situ fixation is the most common treatment for SCFE, where the femoral head is realigned on the neck through screw insertion to prevent further deformity during adolescence. The topic of screw removal is quite controversial. If the screws are left in the patient, there is the potential that fractures may occur later in life due to stress risers, yet screw removal requires a second surgical operation. In addition, there is no standard screw that is used for the procedure. Different physicians prefer various types of screws including titanium vs. non-titanium, cannulated vs. non-cannulated and threaded vs. partially-threaded. Therefore, the purpose of this research project is to determine the amount of torque required to remove various types of orthopaedic screws after closure of the physis. This analysis will quantify how various screws perform during screw removal and provide insight into tissue damage that may occur due to screw removal. The ultimate goal of this study is to determine the optimal screw to use during the procedure that will cause the least amount of damage after bone growth has occurred around the screw.