The outcome of modified Dunn's procedure for moderate and severe slipped capital femoral epiphysis

Abstract

The aim of this study was to evaluate the outcome of 20 children with moderate-severe slipped capital femoral epiphysis (SCFE) with open physes, treated by the modified Dunn's procedure, as regards:  intraoperative findings, clinical and  radiographic outcomes, and postoperative complication rate.

PATIENTS AND METHODS: A prospective study was executed , between 2012 and 2016, for treating  moderate-severe SCFE with modified Dunn  procedure  in 20 hips of 20 patients,  with a mean age of 13.6 ± 3.4 years  (range: 10 – 16.5 years). Seven cases were 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