The modified Dunn procedure for slipped capital femoral epiphysis does not reduce the length of the femoral neck | [Pakistan Journal of Medical Sciences • 2016]

Author(s):

1. Dan Cosma: Department of Radiology, University of Medicine and Pharmacy “Iuliu Haţieganu”,Cluj-Napoca, Romania.

2. Dana Elena Vasilescu: Department of Pediatric Orthopedics University of Medicine and Pharmacy “Iuliu Haţieganu”,Cluj-Napoca, Romania.

3. Andrei Corbu: Department of Pediatric Orthopedics University of Medicine and Pharmacy “Iuliu Haţieganu”,Cluj-Napoca, Romania.

4. Madalina Valeanu: Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy “Iuliu Haţieganu”,Cluj-Napoca, Romania.

5. Dan Vasilescu: Department of Radiology, University of Medicine and Pharmacy “Iuliu Haţieganu”,Cluj-Napoca, Romania.

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.

Page(s): 379-384

DOI: 10.12669/pjms.322.8638

Published: Journal: Pakistan Journal of Medical Sciences, Volume: 32, Issue: 2, Year: 2016

Keywords:

Slipped capital femoral epiphysis , Femoroacetabular impingement FAI , Modified Dunn procedure , Pinning in situ , Open surgical dislocation

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