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. 2016 Mar-Apr;32(2):379-84.
doi: 10.12669/pjms.322.8638.

The modified Dunn procedure for slipped capital femoral epiphysis does not reduce the length of the femoral neck

Dan Cosma  1 , Dana Elena Vasilescu  2 , Andrei Corbu  3 , Mădălina Văleanu  4 , Dan Vasilescu  5
Affiliations

The modified Dunn procedure for slipped capital femoral epiphysis does not reduce the length of the femoral neck

Dan Cosma et al. Pak J Med Sci. 2016 Mar-Apr.

Abstract

Objective: The treatment of slipped capital femoral epiphysis (SCFE) is evolving, with the development of new surgical techniques. |We wanted to study if modified Dunn procedure restores the normal alignment of the proximal femur and the risk of avascular necrosis is increased.

Methods: This is a single centre, retrospective study, comparing the outcomes of in situ pinning and modified Dunn procedure. Between 2001 and 2014, 7 children (7 hips) underwent the modified Dunn procedure and 10 children (10 hips) pinning in situ for stable and unstable SCFE. Mean age of the patients was 12.7 years with a median follow-up of 18 months.

Results: The radiological parameters improved in the modified Dunn procedure group, while the length of the femoral neck didn't change significantly (p=0.09). Postoperative clinical outcomes were slightly better in the modified Dunn procedure group (6 hips out of 7 had good and excellent results) compared to the pinning in situ group (8 good and excellent results out of 10 hips) (p=0.04). No avascular necrosis was found and there were no cases of chondrolysis.

Conclusion: Radiographic parameters of the proximal femur assessed in our study improved in all hips that underwent modified Dunn procedure, without the creation of secondary deformities.

Keywords: Femoroacetabularimpingement (FAI); Modified Dunn procedure; Open surgical dislocation; Pinningin situ; Slipped capital femoral epiphysis.

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Figures

Fig.1
Fig.1
This is an illustrative case of a 13-year-old boy with a stable left slipped capital femoral epiphysis. (A) Preoperative anteroposterior and (B) lateral views. (C – D) Early postoperative anteroposterior and lateral views after modified Dunn procedure. (E) 18 months after the modified Dunn procedure and screws removal. The physis and trochanteric osteotomy healed without complications. There is no evidence of AVN or chondrolysis. The anterior head-neck offset is fully restored.
Fig.2
Fig.2
This is an illustrative case of an 11-year-old boy with a stable right SCFE. (A – B)Anteroposterior and lateral views before pinning in situ.(C – D) Postoperative anteroposterior and lateral views after pinning in situ. (E – F) Anteroposterior and lateral views after screws removal and re-slip of the right capital femoral epiphysis after 18 months.(G) Lateral view after re-pinning in situ.
See this image and copyright information in PMC

References

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