[The modified Dunn procedure to treat severe slipped capital femoral epiphysis].

Ziebarth, Kai; Steppacher, Simon Damian; Siebenrock, Klaus-Arno (2019). [The modified Dunn procedure to treat severe slipped capital femoral epiphysis]. Der Orthopäde, 48(8), pp. 668-676. Springer 10.1007/s00132-019-03774-x

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The modified Dunn procedure enables restoration of the proximal femoral anatomy and normal hip function in patients with slipped capital femoral epiphysis (SCFE). Surgery is indicated in severe SCFE and in hips with a moderate slip angle and impaired function. To prevent further dislocation of the femoral head, the authors recommend non-weightbearing until surgery, since an accurate evaluation of slip stability is not possible in the clinical setting. Only a well-trained orthopedic surgeon with a high level of expertise in hip preservation surgery should perform this procedure. Precise knowledge of the vascular anatomy of the proximal femur is essential to perform successful surgery with low rates of complications such as avascular necrosis of the femoral head. Surgical hip dislocation with osteotomy of the greater trochanter is the approach used. After arthrotomy, stability of the physis is checked. To prevent rupture of the retinacular vessels in hips with an unstable physis, these heads are prophylactically pinned before dislocation out of the socket. Blood supply to the femoral head as well as intraarticular damage can be judged in the dislocated position of the femoral head. The retinacular flap preserves epiphyseal perfusion while the femoral head is dislocated from the femoral neck. Resection of posteromedial callous formation from the femoral neck as well as removal of the remaining physis from the femoral head prevent stress on the retinacular vessels after reduction of the femoral head (epiphysis) on the neck.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Surgery

UniBE Contributor:

Ziebarth, Kai; Steppacher, Simon Damian and Siebenrock, Klaus-Arno

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1433-0431

Publisher:

Springer

Language:

German

Submitter:

Kathrin Aeschlimann

Date Deposited:

25 Oct 2019 13:58

Last Modified:

25 Oct 2019 14:06

Publisher DOI:

10.1007/s00132-019-03774-x

PubMed ID:

31267140

Uncontrolled Keywords:

Avascular necrosis Femoral head Hip dislocation Osteotomy Treatment of SCFE

BORIS DOI:

10.7892/boris.134128

URI:

https://boris.unibe.ch/id/eprint/134128

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