Modified Dunn osteotomy using an anterior approach used to treat 26 cases of SCFE

Niane, M.M.; Kinkpé, C.V.A.; Mohamed, Doumbouya; Sarr, Lamine; Gueye, A.B.; Sané, A.; Seye, S.

doi:10.1016/j.otsr.2015.10.005

Cited by 9 publications

(2 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Незначительное Показания и противопоказания к модифицированной операции Dunn, которых мы придерживались в своей работе, как и примененная нами техника вмешательства, полностью согласуются с данными литературы [20][21][22]. Между тем в отли чие от большинства авторов [23][24][25][26] у нас отсутствует опыт выполнения этой операции при ЮЭГБК со смещением эпифиза средней степени тяжести. Клинико-рентгенологическая характеристика наших пациентов в рассматриваемые сроки послеоперационного периода, как и количество ранних осложнений хирургического лечения, также соответствуют литературным данным [27][28][29].…”

Section: результаты и их обсуждениеunclassified

Our experience of the modified Dunn procedure in children with slipped capital femoral epiphysis (preliminary results)

Barsukov

Борисович²,

Баиндурашвили

et al. 2020

Pediatr Traum Orthop Reconstr Surg

View full text Add to dashboard Cite

Backgrоund. The spatial correlations of the epiphysis and acetabulum during slipped capital femoral epiphysis (SCFE) with acute (at the stage of partial synostosis) and chronic displacement of the epiphysis to a severe degree were restored using different extra-articular corrective hip osteotomy techniques and the standard Dunn procedure. A large number of postoperative ischemic complications and/or the remaining residual displacement of the epiphysis, which is the cause of FAI, was the rationale for improving traditional surgical methods. In 2007, a modified technique of the classic Dunn procedure was proposed using a low traumatic surgical hip dislocation. Aim. The aim of the study was to evaluate the effectiveness of the modified Dunn procedure in the treatment of children with SCFE. Materials and methods. The data of preoperative and postoperative clinical and radiological studies of 10 patients (six males and four females) aged 1115 years who were suffering from SCFE with severe epiphyseal displacement were analyzed. In five cases, the displacement of the epiphysis was chronic, in four cases it was acute associated with chronic, and in one case it was primarily acute. In the joints with acute displacement at the time of surgery, there were signs of partial synostosis at the level of the epiphyseal growth plate. All children underwent a modified Dunn procedure with strict adherence to the authors technique. The maximum follow-up period was 1.5 years. Results. Evaluation of the most short-term anatomical and functional treatment results confirmed a satisfactory result in half (5/10) of the observations with the possibility of an additional three. In two cases, a poor treatment result was obtained due to the development of an early complication in the form of aseptic necrosis of the femoral head. The number of early complications of surgical treatment that were recorded is consistent with the literature. Conclusions. To date, the modified Dunn procedure is the only intervention with a relatively small number of complications that provides a complete and accurate reposition of the epiphysis, thereby eliminating FAI in the above anatomical situations. The modified Dunn procedure can be characterized as an effective intervention for SCFE with severe, acute (at the stage of partial synostosis), and chronic displacements of the epiphysis. The authors intend to continue using the procedure in practice.

show abstract

Section: результаты и их обсуждениеunclassified

Our experience of the modified Dunn procedure in children with slipped capital femoral epiphysis (preliminary results)

Barsukov

Борисович²,

Баиндурашвили

et al. 2020

Pediatr Traum Orthop Reconstr Surg

View full text Add to dashboard Cite

show abstract

“…4,5 Avascular necrosis (AVN) remains a significant concern with reported rates varying from 0% to as high as 67% in unstable SCFE. 4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Particularly in unstable SCFE, there is an inherent risk of AVN associated with the pathology itself, and the iatrogenic risk of AVN associated with the modified Dunn procedure remains unclear. 4,14 In stable SCFE, the AVN risk may be purely iatrogenic and several recent publications reporting high AVN rates for the modified Dunn procedure in stable SCFE advise against its use.…”

Section: Introductionmentioning

confidence: 99%

The modified Dunn procedure can be performed safely in stable slipped capital femoral epiphysis but does not alter avascular necrosis rates in unstable cases: A large single-centre cohort study

Birke

George

Gibbons

et al. 2021

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

Purpose: The modified Dunn procedure for slipped capital femoral epiphysis (SCFE) remains controversial. We reviewed our series over ten years to report our learning curve, experience with intraoperative monitoring of femoral head perfusion and its correlation with postoperative Single-photon emission computed tomography (SPECT-CT) bone scan and femoral head collapse in stable and unstable SCFE. Methods: We retrospectively assessed 217 consecutive modified Dunn procedures performed between 2008 and 2018. In all, 178 had a minimum of one-year follow-up (mean 2.7 years (1 to 9.2)) including 107 stable and 71 unstable SCFE. Postoperative viability was assessed with a three-phase Tc99 bone scan and SPECT-CT. From 2011, femoral head perfusion monitoring was performed intraoperatively using a Codman Intracranial Pressure transducer and the capsulotomy was modified. Results: With intraoperative monitoring, the rate of non-viable femoral heads in stable SCFE decreased from 21.1% to 0% (p < 0.001). In unstable SCFE, the rate remained unchanged from 35.7% to 29.8% (p = 0.669). The positive predictive value (PPV) of pulsatile monitoring for no collapse was 100% in stable and 89.1% in unstable SCFE. Pulsatile monitoring and viable SPECT-CT bone scan gave a 100% PPV for all cases. A non-viable scan defines those hips at risk of collapse since 100% of stable and 68.2% of unstable hips with non-viable bone scans went on to collapse. Conclusion: Our protocol enables safe performance of this complex procedure in stable SCFE with intraoperative monitoring being a reliable asset. The avascular necrosis rate for unstable SCFE remained unchanged and further research into its best management is required. Level of evidence: Level III

show abstract

Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis

et al. 2017

View full text Add to dashboard Cite

Background Several aspects of slipped capital femoral epiphysis (SCFE) treatment remain controversial. Loder's work has been instrumental in changing our understanding and approach to the management of the condition when he introduced the concept of ''slip instability'' and showed that avascular necrosis (AVN) developed in 47% of unstable slips but none of the stable slips. As the two types of SCFE behave differently in terms of presentation, progress and complications, we approached them as two different conditions to highlight these differences. This paper focuses on treatments of stable SCFE. Materials and methods An extensive literature search was carried out from multiple databases. One thousand six hundred and twenty-three citations were screened. Three hundred and sixteen full publications were obtained for further scrutiny. Fifty-eight studies (2262 hips) were included in the review. These studies evaluated 6 interventions. AVN was chosen as a surrogate for bad outcome. Secondary outcomes were chondrolysis (CL), femoro-acetabular impingement (FAI), osteoarthritis (OA) and patients' reported outcomes. The latter were pooled when they met our predefined criteria. Results The type of surgical intervention was an important risk factor. Pinning in situ (PIS) was associated with the lowest AVN rate (1.4%). Moreover, the CL, FAI and OA rates were relatively low in patients who underwent PIS.

show abstract

Modified Dunn osteotomy using an anterior approach used to treat 26 cases of SCFE

Abstract: IV, retrospective treatment study.

Cited by 9 publications

References 42 publications

Our experience of the modified Dunn procedure in children with slipped capital femoral epiphysis (preliminary results)

Our experience of the modified Dunn procedure in children with slipped capital femoral epiphysis (preliminary results)

The modified Dunn procedure can be performed safely in stable slipped capital femoral epiphysis but does not alter avascular necrosis rates in unstable cases: A large single-centre cohort study

Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis

Contact Info

Product

Resources

About