The modified Dunn procedure for slipped capital femoral epiphysis: the Bernese experience

Journal of Children's Orthopaedics
M TannastK A Siebenrock

Abstract

Based on previous investigations on the vascular blood supply to the femoral head, a technique for anatomical reduction after slipped capital femoral epiphysis was developed. This technique is a modification of the original technique by Dunn using a retinacular soft-tissue flap. This allows the visual control of the epiphyseal vascular blood supply. We report the experience at the inventor's institution with a critical discussion of the available literature. Using a trochanteric osteotomy for surgical dislocation of the hip, a retinacular soft tissue flap is created containing the deep branch of the medial femoral circumflex artery, the external rotators and the capsule. The femoral epiphysis can be mobilised safely and reduced on the femoral neck after resection of the almost constantly present reactive metaphyseal callus. In our institution, the rate of avascular necrosis with 2% is comparably low to Dunn's original results. It is only present in cases where no bleeding was already evident before reduction of the epiphysis. The ten-year long-term results are favorable in these cases with a good functional result and only little progression of osteoarthritis. However, other authors have reported higher rates of avascular necro...Continue Reading

References

Aug 1, 1978·The Journal of Bone and Joint Surgery. British Volume·D M Dunn, J C Angel
Nov 1, 1957·The Journal of Bone and Joint Surgery. British Volume·J E HALL
Oct 18, 2007·Operative Orthopädie und Traumatologie·Michael LeunigReinhold Ganz
Jan 15, 2009·Clinical Orthopaedics and Related Research·Kai ZiebarthYoung-Jo Kim
Jun 15, 2010·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Ralf SchoenigerReinhold Ganz
Aug 10, 2010·International Orthopaedics·Christoph ZilkensRüdiger Krauspe
Dec 17, 2010·The Journal of Bone and Joint Surgery. American Volume·Theddy SlongoKai Ziebarth
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Jun 29, 2012·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Morteza KalhorReinhold Ganz
Feb 12, 2013·Clinical Orthopaedics and Related Research·Kai ZiebarthReinhold Ganz
Apr 5, 2013·The Journal of Bone and Joint Surgery. American Volume·Wudbhav N SankarJudson W Karlen
Apr 2, 2014·Journal of Pediatric Orthopedics·Christopher D SouderDennis R Wenger
Sep 12, 2014·Journal of Pediatric Orthopedics·Vidyadhar V UpasaniJames R Kasser
Dec 17, 2014·Clinical Orthopaedics and Related Research·Eduardo N NovaisErnest L Sink
Nov 1, 2016·Clinical Orthopaedics and Related Research·Vidyadhar V UpasaniUNKNOWN International SCFE Study Group
Feb 9, 2017·SICOT-J·Mohammed ElmarghanyAlessandro Massè
Feb 15, 2017·Clinical Orthopaedics and Related Research·Kai ZiebarthKlaus A Siebenrock

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Citations

Mar 20, 2018·Journal of Pediatric Orthopedics·Matthew R SchmitzWudbhav N Sankar
Jul 4, 2019·Der Orthopäde·K ZiebarthK A Siebenrock
Aug 21, 2020·Zeitschrift für Orthopädie und Unfallchirurgie·Daniela WeinmannAndrea Meurer
Oct 1, 2020·International Orthopaedics·Paulo RegoReinhold Ganz
May 23, 2017·Journal of Children's Orthopaedics·R Krauspe, S Weinstein
Oct 20, 2020·Journal of Hip Preservation Surgery·Ajay C LallDamian R Griffin
Dec 29, 2020·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Masayoshi SaitoVikas Khanduja
Nov 19, 2020·EFORT Open Reviews·Markus S HankeKlaus A Siebenrock

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