Key result
The modified Dunn procedure for moderate and severe SCFE yielded a mean postoperative Harris hip score of 93.7 and corrected the mean slip angle from 53.9 to 5.1 degrees.
Why the study?
Moderate to severe slipped capital femoral epiphysis leads to premature osteoarthritis from femoroacetabular impingement, while the modified Dunn procedure aims to restore normal anatomy and preserve physeal blood supply.
Does the modified Dunn procedure improve clinical and radiological outcomes in patients with moderate and severe slipped capital femoral epiphysis?
Observational (n=15)
Does the modified Dunn procedure improve clinical and radiological outcomes in patients with moderate and severe slipped capital femoral epiphysis?
The modified Dunn procedure provides good short-term clinical and radiological outcomes with a low complication rate for moderate and severe slipped capital femoral epiphysis.
Supports short-term use of modified Dunn in moderate-severe SCFE; hypothesis-generating for randomized trials on long-term results.
Background: Moderate to severe slipped capital femoral epiphysis leads to premature osteoarthritis resulting from femoroacetabular impingement. Modified dunn procedure restore the normal anatomy, complete correction of the slip angle, and minimize the probability of cam-type FAI with preservation of physeal blood supply. Patients, Methods: A prospective study was conducted on 15 patients with moderate and severs SCFE were treated with modified dunn procedure during the period from March 2017 to February 2020 , 12 males (80%) and 3 females (20%) with mean age was 15.2 years at the date of surgery The Right hip was affected in 9 patients (60%) and the left hip in 6 patients (40%). 10 cases were stable, while 5 cases were unstable. The mean follow up period was 15.1 month. Results: Postoperatively, the harris hip score (HHS) ranged from 60 to 100 with mean value 93.7 (SD was 13), WOMAC score ranged from 0 to 20 with mean value 3.7 (SD was 5.5) and the Heyman and Herndon score was excellent-good in 13 cases (86.7%),and poor in two cases (13.3%). Radiologically, all parameters showed significant improvement with the mean slip angle corrected from 53.90(SD 11.7) preoperatively to 5.10(SD 5.7) postoperatively, the mean alpha angle corrected from 1000(SD 14.1) preoperatively to 51.9 (SD 5.3) postoperatively. AVN and implant removal occurred in only two cases (13.3%).Conclusion: Capital realignment through the modified dunn procedure is an effective and safe treatment option for moderate and severe SCFE in patients with open physes as it allows anatomical restoration of hip anatomy thus preventing FAI with its sequalae and and provide good short-term outcome with low complication rate.
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El-Sayed et al. (2021) conducted an observational in Moderate and severe slipped capital femoral epiphysis (SCFE) (n=15). Modified Dunn procedure was evaluated on Harris hip score (HHS). The modified Dunn procedure for moderate and severe SCFE yielded a mean postoperative Harris hip score of 93.7 and corrected the mean slip angle from 53.9 to 5.1 degrees.
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