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

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Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Modified Dunn procedure has become popular for the treatment of severe cases of slipped capital femoral epiphysis (SCFE). We assessed the outcomes in a consecutive series of thirty Indian adolescents treated by the modified Dunn procedure.

Materials and methods

All patients treated by the modified Dunn procedure by a single senior Paediatric Orthopaedic surgeon over six years were retrospectively reviewed. Only moderate and severe slips undergoing modified Dunn procedure were included. Clinical records and radiographs were reviewed to obtain demographic information; to classify the slips by duration of symptoms, severity and physeal stability; and to assess the outcomes by Harris Hip Score, radiological changes and rate of complications.

Results

Thirty consecutive hips with 19 stable and 11 unstable slips were included. Mean age was 13.05 years, 25 boys and 5 girls; six were acute slips, six chronic and eighteen acute-on-chronic. There were 20 moderate and 10 severe slips. Slip angle correction was on average 43.63° ± 8.42° (p < 0.001). At a mean follow-up of 25.36 months, the slip angle averaged 9.9° ± 3.78°, and alpha angle was 33.63° ± 4.14. The average Harris Hip Score was 81.833 ± 7.12 points, with six excellent, 17 good, six fair and one poor result. Osteonecrosis occurred in two hips (6.6%). One hip had post-operative subluxation which was corrected.

Conclusion

This study adds to the evidence that the modified Dunn procedure is safe, reliable and reproducible. It should be the first choice for the treatment of moderate and severe SCFE.

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Contributions

MVA: Concepts, design, definition of intellectual content, literature search, clinical studies, experimental studies, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing, manuscript review, guarantor. DAP: design, literature search, manuscript preparation, manuscript editing, manuscript review. SVV: concept, design, definition of intellectual content, clinical studies, data acquisition, data analysis, manuscript preparation, manuscript editing.

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Correspondence to Mandar V. Agashe.

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“The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.”

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All the procedures performed in this study were in accordance with the ethical standards of the National research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Since it was a retrospective study, a formal consent was not necessary.

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Agashe, M.V., Pinto, D.A. & Vaidya, S. Modified Dunn Osteotomy for Moderate and Severe Slipped Capital Femoral Epiphysis – A retrospective study of thirty hips. JOIO 55, 100–108 (2021). https://doi.org/10.1007/s43465-020-00156-w

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  • DOI: https://doi.org/10.1007/s43465-020-00156-w

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