Abstract

PRAGLIA, Francisco; VISONA DALLA POZZA, Daniel; SUEIRO, Jorge  and  STEFANO, Eduardo. Deslizamientos epifisarios femorales proximales >30º: Procedimiento de Dunn modificado Evaluación anatómica y funcional en una cohorte retrospectiva. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2013, vol.78, n.4, pp.199-209. ISSN 1852-7434.

Background: The residual deformity resulting from a moderate and/or severe proximal femoral epiphysis slipping (SCFE) leads to premature osteoarthritis due to impingement. The objectives were to assess improvement in the anatomy of the proximal femur and to evaluate hip function in patients with SCFE >30° treated with the modified Dunn procedure. Methods: A retrospective cohort of patients with SCFE >30° treated with hip dislocation control and modified Dunn procedure. Preoperative and postoperative clinical and radiographic measurements, intra-operative findings and functionality using Harris and D'Aubigne & Postel scores were evaluated. Results: Thirteen cases, median age 12 years, median follow-up 14 months. Southwick slip angle showed a statistically significant decrease (preoperative: 75, IR 67-85; postoperative: 10, IR 5-17) (p <0.001). The head-neck offset radius obtained a significant improvement (preoperative -0.13; postoperative: 0.12) (p 0.002). The 69.2% of patients presented intraarticular damage. The average scores for functionality were 14.6 (excellent improvement) and 83.4 (good). Complications: avascular necrosis 15.3% and chondrolysis 15.3%. Conclusions: This technique restores the anatomy of the proximal femur and hip functionality in the short term. Although we do not have long-term results, at least in theory they would be good. However, the dislocation controlled with modified Dunn procedure is not free of complications and the risk of avascular necrosis and chondrolysis persists.

Keywords : Slipped capital femoral epiphysis; Surgical dislocation of the hip; Modified Dunn procedure.

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