Modified Dunn Osteotomy for Moderate and Severe Slipped Capital Femoral Epiphysis – A retrospective study of thirty hips

Agashe, Mandar; Pinto, Deepika; Vaidya, Sandeep V.

doi:10.1007/s43465-020-00156-w

Cited by 10 publications

(12 citation statements)

References 37 publications

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“…Dunn, in 1964, described a promising surgical technique for subcapital reorientation with an AVN risk of only 4% [ 18 ]. Recent studies show that the modified Dunn procedure done through Ganz safe hip dislocation provides excellent results both radiologically and functionally [ 19 , 20 ]. Our patient is a case of Grade 2 unstable slip managed by modified Dunn procedure through Ganz surgical hip dislocation has resulted in very good outcome and complete correction of slip angle.…”

Section: Discussionmentioning

confidence: 99%

Slipped Capital Femoral Epiphysis Managed by Ganz Safe Surgical Dislocation of Hip: A Case Report with 2 Years Follow-up

Packkyarathinam¹,

Jeyaraman²,

Jeyaraman³

et al. 2022

JOCR

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Introduction: Slipped capital femoral epiphysis (SCFE) is commonly managed by in situ screw fixation. However, higher grades of slips require restoration of normal anatomy of the femoral head without compromising the blood supply. Case Report: A 16-year-old adolescent male presented with the left hip pain and progressive limping for 4 days with no history of previous trauma. On examination, the patient had severe tenderness and gross restriction of movements. Radiological examination revealed Grade 2 acute on chronic SCFE with unstable slip. Modified Dunn procedure through Ganz surgical hip dislocation facilitated the complete restoration of normal anatomy without avascular necrosis of femoral head changes at 2 years of follow-up. Conclusion: Ganz safe surgical dislocation of the hip is safe for the femoral head, preserving its blood supply in toto and the modified Dunn procedure facilitated the complete restoration of normal anatomy even in acute on chronic type of SCFE cases.

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Section: Discussionmentioning

confidence: 99%

Slipped Capital Femoral Epiphysis Managed by Ganz Safe Surgical Dislocation of Hip: A Case Report with 2 Years Follow-up

Packkyarathinam¹,

Jeyaraman²,

Jeyaraman³

et al. 2022

JOCR

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“…Although SCFE is a common disease of the hip joint it creates a big challenge to treat its subsequent deformation from the surgical perspective. Avascular necrosis (AVN) and chondrolysis occur more often in the group of patients operated on than in patients without surgical intervention or only with neck and head osteosynthesis in situ (without reduction of deformation) [ 11 – 13 ]. The osteosynthesis of the neck and head in situ causes deformation leading to earlier degenerative changes of the hip joint and results in a femoro-acetabular-impingement.…”

Section: Discussionmentioning

confidence: 99%

“Slipped capital femoral epiphysis in a 25-year-old hypogonadic man with a large cranial chondroma: causality or coincidence? “

et al. 2021

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Background Slipped capital femoral epiphysis (SCFE) is a hip disorder frequently occurring in adolescence. In adults it is rare and so far very few cases have been documented. Case presentation This report presents a 25-year-old patient diagnosed with an anterior fossa giant chondroma, hypogonadotropic hypogonadism, and SCFE. The patient underwent surgical and hormonal therapy. His symptoms revealed, and he became a father. Conclusions Every patient diagnosed with SCFE in adulthood should undergo endocrinological assessment based on physical examination and laboratory tests.

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“…After detailed evaluation of the full text of the remaining 27 studies, based on inclusion and exclusion criteria, 23 papers were selected to be include in the present review [ 16 – 38 ]; 4 articles fulfilled the inclusion criteria but reported fewer than 10 cases.…”

Section: Main Textmentioning

confidence: 99%

“…The incidence of implant removal ranged from 2.3 to 29.48%. In five papers [ 23 , 34 , 35 , 37 , 38 ] the authors observed hip instability with an incidence from 3.3 to 17.6% that required a second operation. This complication, as reported by some authors [ 42 ] may be directly related to SCFE such as damages of the acetabular labrum or the acetabular cartilage, causes not related to SCFE (acetabular orientation or poor quality of the soft tissues) and causes related to the surgical operation.…”

Section: Main Textmentioning

confidence: 99%

“…Regarding the stability of the SCFE, many papers report their results of stable and unstable hips together, without differentiating them in terms of clinical results and complications, although the majority of the hips in these studies were stable (259 stable hips vs 121 unstable hips reported in 13 papers) [ 16 – 20 , 22 , 23 , 27 , 30 , 32 , 36 – 38 ]. Davies et al [ 34 ], reported a cohort of 48 SCFE (17 stable and 31 unstable), differentiating their results according to the hip stability.…”

Section: Main Textmentioning

confidence: 99%

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Surgical treatment of slipped capital femoral epiphysis (SCFE) by Dunn procedure modified by Ganz: a systematic review

Gorgolini

Caterini

Efremov

et al. 2022

BMC Musculoskelet Disord

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Background Treatment of SCFE is still controversial, especially in moderate and severe forms. Dunn osteotomy performed with the Ganz approach became very popular in the last decade, although it is a complicated and challenging surgical procedure with a risk of AVN. The aim of our study was to analyze the current literature verifying the effectiveness of this surgical procedure, with specific attention to the incidence of AVN and other complications. Main body A systematic review on the subject was performed according to the PRISMA guidelines. A literature search was performed by searching all published articles about the topic in the databases. The articles were screened for the presence of the following inclusion criteria: patients affected by slipped capital femoral epiphysis (SCFE) surgically treated by Dunn osteotomy using the Ganz surgical approach. All the patients affected by pathologies other than SCFE, treated without surgery or with procedures not including a surgical hip dislocation were excluded. Based on inclusion and exclusion criteria, 23 studies were included in our systematic review. Selected articles were published from 2009 to 2021 and they included 636 overall hips. According to the selected articles, Dunn osteotomy modified by Ganz, performed by an experienced surgeon, allows for anatomical reduction of moderate or severe SCFE with a low incidence of AVN. Conclusions The few papers with long term follow-up, reported no progression of hip osteoarthritis, however, since the patients are adolescent at surgery, longer follow-up studies are needed to validate this statement. It is still debated if better results are obtained in stable or unstable SCFE. The indication of this procedure in mild SCFE remains controversial. Level of evidence 3

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Modified Dunn Osteotomy for Moderate and Severe Slipped Capital Femoral Epiphysis – A retrospective study of thirty hips

Cited by 10 publications

References 37 publications

Slipped Capital Femoral Epiphysis Managed by Ganz Safe Surgical Dislocation of Hip: A Case Report with 2 Years Follow-up

Slipped Capital Femoral Epiphysis Managed by Ganz Safe Surgical Dislocation of Hip: A Case Report with 2 Years Follow-up

“Slipped capital femoral epiphysis in a 25-year-old hypogonadic man with a large cranial chondroma: causality or coincidence? “

Surgical treatment of slipped capital femoral epiphysis (SCFE) by Dunn procedure modified by Ganz: a systematic review

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