Surgical Hip Dislocation Technique in Treatment of Patients with Slipped Capital Femoral Epiphysis

Abstract

Purpose: to evaluate the efficiency of modified Dunn procedure for treatment of severe slipped capital femoral epiphysis.Material and Methods. The authors used the modified Duim procedure for treatment of 6 patients with SCFE aged from 10 to 13 years and displacement degree over 55°. Chronic disease form was reported in one patient, acute displacement along the chronic process was reported in 5 patients. All patients had a stable form of SCFE by Loder classification. Surgical procedure was performed within 6 to 12 months from the onset of disease.Results. Normal anatomical relations in the hip joint were restored in all patients. During follow up from 18 until 48 months the patients did not demonstrate aseptic femoral head necrosis or chondrolysis. Adolescents did not complain on pain or hip motion limitations. Treatment outcomes assessment by Harris hip score was 97 points.Conclusion. Based on outcomes of the modified Durm procedure the authors conclude that the method provides for complete restoration of the anatomical relations between femoral neck and epiphysis and, thus, the hip joint biomechanics. Femur dislocation allows to form an extended flap to ensure epiphysis perfusion which improves overall blood supply in the femoral head and consequently decreases the risk of aseptic necrosis and chondrolysis