Windshield-wiper loosening: a complication of in situ screw fixation of slipped capital femoral epiphysis.
Windshield-wiper loosening: a complication of in situ screw fixation of slipped capital femoral epiphysis.
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挡风玻璃雨刷松动：股骨头骨骺滑脱的原位螺钉固定的并发症。
DOI：
10.1097/01241398-199309000-00010
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
George S. Bassett
中科院分区：
文献类型：
--
作者：
Gregory B. Maletis;George S. Bassett
对采用空心钛螺钉原位螺钉固定治疗股骨头骨骺滑脱 (SCFE) 的患者进行了回顾性研究。在至少进行了 1 年随访的 18 个髋关节中，有 3 个髋关节发生了股骨头空心螺钉的挡风玻璃刮水器松动。在所有这三种情况下，螺钉均从股骨前外侧皮质突出 > 1.5 厘米。我们假设，随着髋部运动，突出的螺钉被前外侧软组织切换，在股骨头中引起挡风玻璃刮水器效应，最终导致螺钉松动。我们认为，使螺钉从阔筋膜突出是挡风玻璃刮水器机构导致螺钉松动的潜在原因，现在通常将螺钉头放置在距股骨前外侧皮层 1.5 厘米的范围内。
A retrospective review of patients treated for slipped capital femoral epiphysis (SCFE) by in situ screw fixation with a cannulated titanium screw was performed. Of the 18 hips with at least 1-year follow-up, windshield-wiper loosening of the cannulated screw in the femoral head had occurred in three. In all three cases, the screw had been left protruding > 1.5 cm from the anterolateral cortex of the femur. We postulate that with hip motion the protruding screw is toggled by the anterolateral soft tissues, causing a windshield-wiper effect in the femoral head, leading to eventual screw loosening. We believe that leaving the screw protruding from the fascia lata is a potential source of screw loosening by the windshield-wiper mechanism and now routinely place the screw head within 1.5 cm of the anterolateral cortex of the femur.