Introduction: Treatment of moderate to severe slipped capital femoral epiphysis (SCFE) is controversial. Over the last years, 3 institutions in Argentina adopted the modified Dunn procedure for capital realignment in selected cases of SCFE. Our aim in this study was to evaluate the clinical outcome and the rate of complications of patients who had undergone surgical hip dislocation and capital realignment.
Methods: A multicenter retrospective cohort study of patients who received the modified Dunn procedure from January 2009 to 2013 was performed. Data concerning clinical features, surgical technique, intraoperative findings, and postoperative complications were obtained from all available medical records. The operative results were evaluated on clinical and radiographic criteria.
Results: Twenty patients (21 hips) with a mean of 40.4 months (range, 12 to 84 mo) of follow-up were evaluated. The average Harris Hip score was 76.3 points (range, 40 to 100 points). Seven patients had excellent results, 6 good, 2 fair, and 5 poor. Mean slip angle improved from a preoperative value of 59.1±11.2 degrees to 5.4±2.5 degrees (P=0.001). The mean postoperative alpha angle and neck-shaft angle were 40.8±2 degrees and 131±9.9 degrees, respectively. One patient had a superficial infection that was resolved with oral antibiotics. Six patients had complete osteonecrosis with severe involvement and 4 partial femoral head necrosis with minimal deformity. No patients developed chondrolysis, infection, deep venous thrombosis, heterotopic ossification, nonunion, or nerve palsies.
Discussion: Modified Dunn procedure for treating hip SCFE is a technically demanding surgery with wide variations in the reported outcomes. Although in this series 65% of patients had good or excellent functional results, a high rate of complications was observed. This may be related, among other factors, to the learning curve of the procedure.
Level Of Evidence: Level IV-therapeutic study.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BPO.0000000000000936 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mid-term outcomes of the modified Dunn procedure for slipped capital femoral epiphysis: results from a north African pediatric hip unit.
J Orthop Surg Res
January 2025
Department of Orthopaedics and Trauma Surgery Faculty of Medicine, Assiut University Hospitals, Assiut, 71515, Egypt.
Background: Slipped Capital Femoral Epiphysis (SCFE) is a prevalent pediatric orthopedic condition. Treatment options range from in situ pinning to various osteotomies, with the Modified Dunn procedure gaining significant attention over the past two decades. However, the suitability of this procedure for different SCFE subtypes and the risk of avascular necrosis (AVN), particularly in moderate and severe cases, remains controversial.
View Article and Find Full Text PDFData from the All of Us research program reinforces existence of activity inequality.
NPJ Digit Med
January 2025
Department of Biomedical Engineering, Duke University, Durham, NC, USA.
Large-scale and detailed analyses of activity in the United States (US) remain limited. In this work, we leveraged the comprehensive wearable, demographic, and survey data from the All of Us Research Program, the largest and most diverse population health study in the US to date, to apply and extend the previous global findings on activity inequality within the context of the US. We found that daily steps differed by sex at birth, age, body characteristics, geography, and built environment.
View Article and Find Full Text PDFExperimental medicine study with stabilised native-like HIV-1 Env immunogens drives long-term antibody responses, but lacks neutralising breadth.
EBioMedicine
January 2025
Imperial College London, Department of Infectious Disease, UK. Electronic address:
Background: We report findings from an experimental medicine study of rationally designed prefusion stabilised native-like HIV envelope glycoprotein (Env) immunogens, representative of global circulating strains, delivered by sequential intramuscular injection.
Methods: Healthy adult volunteers were enrolled into one of five groups (A to E) each receiving a different schedule of one of two consensus Env immunogens (ConM SOSIP, ConS UFO, either unmodified or stabilised by chemical cross-linking, followed by a boost with two mosaic Env immunogens (Mos3.1 and Mos3.
To Change or Not to Change: Perceptions and Experiential Knowledge of Tennis Coaches When Modifying Grip Technique.
Sports (Basel)
November 2024
Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, 1 Kingsbury Drive, Bundoora, Melbourne, VIC 3083, Australia.
The purpose of this study was to explore the experiential knowledge of tennis coaches as it related to the development of grip positions in tennis athletes. Accredited tennis coaches (n = 11) completed semi-structured interviews consisting of open-ended questions about their coaching background, the importance of grip positions compared with other areas of foundational development, and their opinions on using physically-constraining tools (PCTs). Two major themes, "Grip positions are an adaptive skill" and "Why and how do I modify an athlete's grip?", were identified.
View Article and Find Full Text PDFRetrospective Analysis of the Clinical and Radiological Outcomes Following Modified Dunn Osteotomy in Patients with Stable, Moderate-to-severe Chronic Slipped Capital Femoral Epiphysis.
Rev Bras Ortop (Sao Paulo)
December 2024
Departamento de Ortopedia e Traumatologia, Faculty of Medicine, GMERS Medical College and General Hospital, Himmatnagar, Sabarkantha, Gujarat, Índia.
The management of slipped capital femoral epiphysis (SCFE) has been completely transformed by modified Dunn osteotomy, a subcapital realignment osteotomy achieved through a safe surgical dislocation technique originally described by Ganz. The purpose of this study was to evaluate the clinical and radiological outcomes of patients with moderate to severe SCFE after modified Dunn osteotomy. A total of 15 patients (16 hips, with one bilateral case; 12 males, 3 females) aged from 10.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!