Peri-Implant Fracture After Distal Femur Percutaneous Epiphysiodesis Using Transphyseal Screws Quality Improvement Case Series

Abstract

Percutaneous epiphysiodesis using transphyseal screws (PETS) is a commonly used technique for guided growth. Technical challenges specific to the distal femur include difficulty obtaining a start point, accurately predicting trajectory across the physis, and achieving adequate thread purchase in the epiphysis. A previously unreported complication is peri-implant fracture. We present a case of peri-implant fracture after epiphysiodesis for leg length discrepancy, ultimately treated with retrograde intramedullary nail fixation. We recommend a modified PETS technique and close attention to orthopedic principles to avoid this unfortunate complication.