Severe slipped capital femoral epiphysis: the Dunn's operation

Orthopaedics & Traumatology, Surgery & Research : OTSR
M LawaneG Lefort

Abstract

Severe slipped capital femoral epiphysis inevitably results into arthritis, making surgical recovery of normal anatomy an attractive objective. This can be achieved by the procedure described by Dunn. However, all published studies report a risk of avascular necrosis. The present series assembles 25 adolescent cases aged 10 to 15 years. There were 16 cases of chronic pure displacement with several months' evolution, including nine exacerbated by an acute accident. In all cases, epiphyseal slippage was severe, between 60 degrees and 90 degrees. Postoperative traction was systematic, for 15 to 21 days. As of 1979, bone scan was prescribed 2 weeks postsurgery to study femoral head vascularization. Reduction was anatomic, except in two cases in which the epiphysis was fixed, respectively in caput valgum and in 15 degrees varus. There were 15 good results, with clinically and radiologically normal hips, but also 10 immediate or late complications: i.e., a complications rate of 40%. The eight immediate complications (32%) comprised four necroses (16%), two of which rapidly evolved into arthritis, three chondrolyses, which all evolved into arthritis, and one mechanical complication. At less than 10 years' FU, two arthrodeses and three...Continue Reading

References

May 24, 2000·Journal of Pediatric Orthopedics·D FronB Herbaux
Aug 30, 2000·The Journal of Bone and Joint Surgery. British Volume·E GautierR Ganz
Oct 18, 2001·The Journal of Bone and Joint Surgery. British Volume·S A PhillipsN M Clarke
Mar 3, 2005·The Journal of Bone and Joint Surgery. American Volume·Harry K W KimFrieder Bauss

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Citations

Nov 4, 2011·The Journal of Bone and Joint Surgery. American Volume·Matthew T ProvencherBrian J Cole
Apr 2, 2014·Journal of Pediatric Orthopedics·Christopher D SouderDennis R Wenger
May 28, 2016·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Balasubramanian Balakumar, Sanjeev Madan
Jun 8, 2018·Journal of Pediatric Orthopedics·Jonathan Wright, Manoj Ramachandran
Nov 11, 2019·Journal of Orthopaedic Surgery and Research·Nicola EbertAlexander S Spiro

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