Modified Dunn Procedure for Unstable Slipped Capital Femoral Epiphysis
The goals of unstable slipped capital femoral epiphysis (SCFE) treatment include preventing further slippage of the epiphysis, avoiding the occurrence of osteonecrosis, and restoring hip function. Although the etiology of osteonecrosis after unstable SCFE remains unsolved, injury to the retinacular nutrient vessels, increased intracapsular pressure secondary to hematoma, and kinking of the vessels have been described. The method of surgical treatment including the time to reduction has also been reported to influence the outcomes of unstable SCFE treatment. The modified Dunn subcapital realignment using the surgical dislocation approach and dissection of the retinacular flap supplying the femoral head is one alternative to the treatment of unstable SCFE. The dissection of the extended retinacular flap allows assessment and protection of the vessels that supply the femoral head.
KeywordsUnstable slipped capital femoral epiphysis SCFE Modified Dunn procedure Surgical hip dislocation Subcapital realignment