Is Surgical Hip Dislocation Necessary in Slip Reduction? The Preliminary Results of Extended Dunn Technique in Slipped Capital Femoral Epiphysis

Abstract

Treatment of severe Slipped Capital Femoral Epiphysis (SCFE) using Modified Dunn technique has become a preferred method, but it carries a steep learning curve. We introduce an alternative technique whereby surgical realignment is performed without a surgical hip dislocation. This series involved five cases (6 hips) of moderate to severe SCFE (slip angle 45⁰ to 60⁰). This series reviewed the short-term complications, functional status, avascular necrosis, and chondrolysis at last review. Slip severity was moderate in two hips and severe in four hips. Five out of six hips demonstrated satisfactory functional and radiological outcome. Only one patient with an absence of pre-reduction femoral head bleeding developed avascular necrosis. None experienced slip progression or chondrolysis. In the treatment of severe SCFE, the Extended Dunn is a less traumatic technique, easier to master when compared to other techniques with short-term functional outcome and complication rate comparable to that of Modified Dunn.