Abstract
Objective The management of slipped capital femoral epiphysis (SCFE) has been completely transformed
by modified Dunn osteotomy, a subcapital realignment osteotomy achieved through a
safe surgical dislocation technique originally described by Ganz. The purpose of this
study was to evaluate the clinical and radiological outcomes of patients with moderate
to severe SCFE after modified Dunn osteotomy.
Methods A total of 15 patients (16 hips, with one bilateral case; 12 males, 3 females) aged
from 10.2 to 17-years-old (mean: 14.3) with stable, moderate to severe, chronic SCFE
(moderate: = 6; severe = 10) underwent modified Dunn osteotomy as treatment. The hip
joint range of motion (ROM), Harris (HHS), and Merle d'Aubigné (MdA) hip scores were
used for clinical assessments. They were assessed radiographically using the Southwick
and Alpha angles.
Results At the most recent follow-up (mean 8.6 years; 3.1–14), the mean hip joint ROM, the
mean HHS (preoperative: 69.20 ± 5.94; postoperative: 86 ± 7.37; p < 0.00001), and the mean MdA score (preoperative: 12.47 ± 1.13; postoperative: 14.27 ± 1.83;
p < 0.00001) all showed statistically significant clinical improvements The radiological
results demonstrated improvements in the mean Southwick angle (preoperative: 56.60 ± 12.89°;
postoperative: 16.40 ± 4.69°; p < 0.00001) and Alpha angle (preoperative: 101.87 ± 12.88°; postoperative: 29.33 ± 7.29°;
p < 0.00001). There were two significant postoperative complications identified: femoral
head avascular necrosis (AVN) and deep infection.
Conclusion According to the study's findings, the modified Dunn osteotomy is a safe, efficient
treatment option for stable moderate-to-severe chronic SCFE with a manageable risk
of complications.
Keywords hip - osteonecrosis - osteotomy - slipped capital femoral epiphysis
