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Clinical Orthopaedics and Related Research

, Volume 467, Issue 3, pp 704–716 | Cite as

Capital Realignment for Moderate and Severe SCFE Using a Modified Dunn Procedure

  • Kai Ziebarth
  • Christoph Zilkens
  • Samantha Spencer
  • Michael Leunig
  • Reinhold Ganz
  • Young-Jo KimEmail author
Symposium: Femoroacetabular Impingement: Current Status of Diagnosis and Treatment

Abstract

Moderate to severe slipped capital femoral epiphysis leads to premature osteoarthritis resulting from femoroacetabular impingement. We believe surgical correction at the site of deformity through capital reorientation is the best procedure to fully correct the deformity but has traditionally been associated with high rates of osteonecrosis. We describe a modified capital reorientation procedure performed through a surgical dislocation approach. We followed 40 patients for a minimum of 1 year and 3 years from two institutions. No patient developed osteonecrosis or chondrolysis. Slip angle was corrected to 4° to 8° and the mean alpha angle after correction was 40.6°. Articular cartilage damage, full-thickness loss, and delamination were observed at the time of surgery, especially in the stable slips. This technique appears to have an acceptable complication rate and appears reproducible for full correction of moderate to severe slipped capital femoral epiphyses with open physes.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Keywords

Femoral Neck Femoral Head Osteonecrosis Heterotopic Ossification Slip Capital Femoral Epiphysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

We thank Dr Martin Beck for assistance with this study.

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Copyright information

© The Association of Bone and Joint Surgeons 2009

Authors and Affiliations

  • Kai Ziebarth
    • 1
  • Christoph Zilkens
    • 2
  • Samantha Spencer
    • 2
  • Michael Leunig
    • 3
  • Reinhold Ganz
    • 4
  • Young-Jo Kim
    • 2
    Email author
  1. 1.Department of Pediatric Surgery, Universitätsklinik InselspitalUniversity of BerneBerneSwitzerland
  2. 2.Department of Orthopaedic SurgeryChildren’s Hospital-BostonBostonUSA
  3. 3.Department of Orthopaedic SurgerySchulthess KlinikZurichSwitzerland
  4. 4.Department of Orthopaedic Surgery, Universitätsklinik InselspitalUniversity of BerneBerneSwitzerland

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