Clin Orthop Surg.  2021 Sep;13(3):415-422. 10.4055/cios19038.

Long-Term Results of Slipped Capital Femoral Epiphysis Treated with the Modified Dunn Procedure in a Colombian Cohort

• Sarassa C
• Carmona D
• Isaza DV
• Rodríguez CR
• Torres AMH

• KMID: 2519264
• DOI: http://doi.org/10.4055/cios19038

Abstract

Background
Slipped capital femoral epiphysis (SCFE) is a severe and catastrophic disorder that affects the hips of adolescents. Many reports about surgical procedures to treat this condition have been published, but to our knowledge, there are no published results of treatment in Latin American patients. This study describes the clinical and radiological results of the modified Dunn procedure with the surgical approach described by Ganz to treat mild to severe SCFE in a cohort of Colombian pediatric patients.
Methods
We retrospectively analyzed 21 patients (22 hips) with SCFE treated with surgical dislocation of the hip from 2005 to 2017. The same pediatric orthopedic surgeon performed all operations. Clinical outcome was assessed using the range of movement and Merle d’Aubigné score, while radiological measurements and assessment included the slip angle and Tönnis score.
Results
The average duration of follow-up was 29 months (range, 12–72 months). Of all cases, 17 presented with acute-on-chronic symptoms. Preoperatively, all 22 hips were classified as poor according to the Merle d’Aubigné score. Preoperative radiological classification showed compromise grade II or III in 20 hips. Last follow-up Merle d’Aubigné score rated 17 cases as good or excellent (p < 0.05). The postoperative radiological classification was grade I or II in all 22 cases, and the Tönnis score was stage II in 3 cases and stage III in 4 cases.
Conclusions
Our results suggest that the modified Dunn osteotomy performed through the Ganz technique could be safely and effectively used to treat patients with mild to severe SCFE.

Keyword

Slipped capital femoral epiphysis; Surgical dislocation; Femur head necrosis