Subcapital Shortening Osteotomy for Severe Slipped Capital Femoral Epiphysis: Preliminary Results of the French Multicenter Study

Ilharreborde, Brice; Cunin, Vincent; Abuamara, Saad

doi:10.1097/bpo.0000000000000854

Cited by 11 publications

(10 citation statements)

References 32 publications

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“…9,14 A experiência internacional com esta técnica foi publicada desde sua descrição, mas há poucos dados acerca da população latino-americana. 5,11,16,[22][23][24][25] Neste estudo, que envolve a maior coorte latino-americana unicêntrica até o momento, demonstramos que o tratamento do EEPF instável pela técnica de Dunn modificada é reprodutível na população brasileira, com risco de NAV de 26% (8 casos). Nossa amostra apresentou demografia semelhante à anteriormente descrita quanto à idade à apresentação, maior prevalência no gênero masculino e predomínio do quadril esquerdo.…”

Section: Discussionunclassified

“… 2 4 5 Therefore, the acceptance of surgical techniques combining anatomical realignment with little secondary deformity while minimizing the risk of AVN, specially the modified Dunn technique, has increased internationally in the last decade. 9 14 The international experience with this technique has been published 5 11 16 22 23 24 25 since its description, but limited data are available for the Latin American population. In the present study, the largest Latin-American single center cohort of unstable SCFE treated through the modified Dunn technique to date, we have shown that the technique is reproducible in the Brazilian population, with a risk of AVN of 26% (8 cases).…”

Section: Discussionmentioning

confidence: 99%

“…It is important to mention that different techniques for capital realignment are used internationally to treat SCFE. For instance, a French multicentric study 23 showed that the preferred technique in that country is a cuneiform osteotomy performed through the Hueter approach without periosteal flap dissection, with a rate of AVN of only 13.3% in 45 unstable slips. 23 Treating slips before 24 hours of evolution with gentle reduction and anterior capsulotomy enabled a single German center 35 to achieve a rate of AVN of 4.7% in 60 unstable slips during a 19 year period.…”

Section: Discussionmentioning

confidence: 99%

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Técnica de Dunn modificada no escorregamento da epífise femoral proximal com instabilidade: Experiência unicêntrica de médio prazo

Vallim

Cruz

Silva

et al. 2023

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Avaliar a segurança e a reprodutibilidade da cirurgia para escorregamento da epífise femoral proximal (EEPF) com instabilidade por meio da técnica de Dunn modificada em uma coorte unicêntrica no Brasil. Métodos Analisamos de forma retrospectiva uma coorte de pacientes submetidos a esse procedimento por um único cirurgião especialista em preservação do quadril. Avaliamos os dados demográficos e os ângulos radiográficos quanto ao risco relativo (RR) de necrose avascular (NAV) por meio do modelo de regressão log-binomial com efeitos simples e aleatórios. Resultados Entre os 30 pacientes (30 quadris) com idade média de 11,79 anos no momento da cirurgia, havia 17 meninos e 18 quadris esquerdos. O procedimento ocorreu em média 11,5 dias após o escorregamento. O tempo médio de acompanhamento foi de 38 meses. O ângulo de Southwick pré-operatório foi, em média, de 60,69° contra 4,52° após o procedimento (p < 0,001). O maior ângulo de escorregamento pré-operatório foi associado ao desenvolvimento de NAV (RR: 1,05; intervalo de confiança de 95% [IC95%]: 1,02–1,07; p < 0,01). A frequência geral de NAV foi de 26,7%. De acordo com a Escala de Quadril de Harris (Harris Hip Score), a função foi boa ou excelente em 86% dos quadris sem complicações, e ruim em 87,5% dos casos com NAV. Não houve relação estatística entre sangramento epifisário e desenvolvimento de NAV (p = 0,82). Conclusão A técnica de Dunn modificada restaura o alinhamento femoral e a função articular após o EEPF com instabilidade na ausência de complicações. Além disso, mostrou-se passível de reprodução em nossa população, com frequência de necrose da cabeça femoral de 26%.

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Section: Discussionunclassified

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Técnica de Dunn modificada no escorregamento da epífise femoral proximal com instabilidade: Experiência unicêntrica de médio prazo

Vallim

Cruz

Silva

et al. 2023

Rev Bras Ortop (Sao Paulo)

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“…14 In recent years, acute correction has been increasingly reported and recommended as first-line treatment in children with severe stable SCFE, albeit in studies with low-quality evidence. 15,16…”

Section: Different Approaches To Treatmentmentioning

confidence: 99%

Stable slipped capital femoral epiphysis with significant deformity

Howard,

Thomas,

Perry

2024

Bone Joint J

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“…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

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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.

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Subcapital Shortening Osteotomy for Severe Slipped Capital Femoral Epiphysis: Preliminary Results of the French Multicenter Study

Abstract: Level IV-therapeutic study.

Cited by 11 publications

References 32 publications

Técnica de Dunn modificada no escorregamento da epífise femoral proximal com instabilidade: Experiência unicêntrica de médio prazo

Técnica de Dunn modificada no escorregamento da epífise femoral proximal com instabilidade: Experiência unicêntrica de médio prazo

Stable slipped capital femoral epiphysis with significant deformity

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

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