The Outcome of Modified Dunn's Procedure for Moderate and Severe Slipped Capital Femoral Epiphysis

Abstract

unstable SCFE. We excluded mild SCFE, endocrinopathy and renal cases. RESULTS: The mean follow-up was 19 ± 9.2 months (range: 12-36 months). Radiologically. all parameters showed significant improvement; with the mean slip angle corrected from 61º± 14.4 preoperatively to 10º ± 10.1 postoperatively, the mean alpha angle corrected from 90.2 ± 21º preoperatively to 49.1 ± 8º postoperatively and the mean femoral neck length difference was 8.1 ± 6 mm. Functionally, the mean Harris hip score (HHS) was 86.2 ± 9.6 and the Heyman and Herndon score was excellent-good in 15 cases (75%), fair in two, poor in two and failed in one. Postoperative major complications occurred in only two cases (10%); AVN in one and secondary FAI in another case. CONCLUSIONS: Modified Dunn's procedure is an effective and safe treatment for moderate-severe SCFE, achieving better anatomical and functional outcome, with a reasonable complication rate.

Treatment of Slipped Capital Femoral Epiphysis with a Modified Dunn Procedure

“…However, in the clinically stable cases, two (13.3%) out of ten patients (53.3%) had partial intraoperative instability. These findings were comparable to that of Zeibarth et al, (19) , Slongo et al, (11) and Othman et al, (22) .…”

“…Our mean HHS was higher than that of the series of Othman et al, (22) , Masquijo, et al, (24) and Passaplan et al, (20) but lower than that of other studies, which may be attributed to involvement of more chronic slips, with some persistent postoperative pain and limited ROM which may improve on the long-term. Excellent and good results according to the Heyman and Herndon score in our study was higher than that in Novais et al, (9) and Othman et al, (22) studies , but lower than that in Elmarghany et al, (23) J study. 11) , Novais et al, (9) , and Abdelazeem, A. H., et al, (21) .…”

“…This coincided with the findings of Elmarghany et al, (23) , Abdelazeem, A. H., et al, (21) . and Othman et al, (22) but did not coincide with the findings of many other authors, who reported implant failure in their studies. In Ziebarth et al, (19).…”

“…In Slongo et al, (11) 8 hips were designated as unstable,10 hips were stable ,3 hips were partially unstable and 2 hips no information was available about the intraoperative stability of the epiphysis. In Othman et al, (22) all clinically-unstable SCFE (7 hips) had intraoperative instability (5 hips grossly unstable and 2 hips partially-unstable). However, even in the clinically stable SCFE, five out of 13 hips had partial intraoperative instability.…”

“…In Abdelazeem, A. H., et al, (21) , 10 were moderate, and 22 patients were severe. Othman et al, (22) , 9 were moderate, and 11 patients were severe, Elmarghany et al, (23) , 2 were mild, 10 were moderate, and 20 patients were severe . In Passaplan et al, (20) , 8 were mild, 8 were moderate, and 2 patients were severe.…”