Abstract
The goals of unstable slipped capital femoral epiphysis (SCFE) treatment include preventing further slippage of the epiphysis, avoiding the occurrence of osteonecrosis, and restoring hip function. Although the etiology of osteonecrosis after unstable SCFE remains unsolved, injury to the retinacular nutrient vessels, increased intracapsular pressure secondary to hematoma, and kinking of the vessels have been described. The method of surgical treatment including the time to reduction has also been reported to influence the outcomes of unstable SCFE treatment. The modified Dunn subcapital realignment using the surgical dislocation approach and dissection of the retinacular flap supplying the femoral head is one alternative to the treatment of unstable SCFE. The dissection of the extended retinacular flap allows assessment and protection of the vessels that supply the femoral head.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Ganz R, Gill TJ, Gautier E, Ganz K, Krügel N, Berlemann U. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2001;83(8):1119–24.
Ganz R, Huff TW, Leunig M. Extended retinacular soft-tissue flap for intra-articular hip surgery: surgical technique, indications, and results of application. Instr Course Lect. 2009;58:241–55.
Leunig M, Slongo T, Kleinschmidt M, Ganz R. Subcapital correction osteotomy in slipped capital femoral epiphysis by means of surgical hip dislocation. Oper Orthop Traumatol. 2007;19(4):389–410. (Article in English, German).
Ziebarth K, Zilkens C, Spencer S, Leunig M, Ganz R, Kim YJ. Capital realignment for moderate and severe SCFE using a modified Dunn procedure. Clin Orthop Relat Res. 2009;467(3):704–16.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Novais, E.N., Kim, YJ. (2018). Modified Dunn Procedure for Unstable Slipped Capital Femoral Epiphysis. In: Hamdy, R., Saran, N. (eds) Pediatric Pelvic and Proximal Femoral Osteotomies. Springer, Cham. https://doi.org/10.1007/978-3-319-78033-7_25
Download citation
DOI: https://doi.org/10.1007/978-3-319-78033-7_25
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-78032-0
Online ISBN: 978-3-319-78033-7
eBook Packages: MedicineMedicine (R0)