Exploring the Long-Term Efficacy of Modified Dunn Osteotomy for Severe SCFE: The Birmingham Experience

Description

In this presentation, Balakumar Balasubramanian from Birmingham discusses the long-term outcomes of modified Dunn osteotomy for managing severe slip in pediatric patients. He highlights the importance of addressing the significant femoral deformity associated with severe slips to prevent lifelong morbidity. Dr Balasubramanian explains that traditional methods like pinning in situ are inadequate due to persisting deformities that can lead to impingement and early osteoarthritis, while open reduction poses risks of avascular necrosis. Explaining the resurgence of interest in modified Dunn procedures following the safe surgical techniques outlined by Reinhold Ganz, he reviews a study conducted between 2006 and 2019 involving 53 patients who underwent the procedure after excluding those with less than 5 years of follow-up.



Key findings reveal that the mean age of presentation was approximately 13.5 years, with a notable incidence of contralateral hip pain and a 16% rate of contralateral slips. Follow-up data indicated that only two out of 53 patients had total hip replacements, with a 12% incidence of avascular necrosis and a high arthroplasty-free survival rate of 98.1% at five years. Although the results align with existing literature, Dr Balasubramanian acknowledges the limitations of a retrospective study and emphasizes the need for further patient assessments to fortify their findings. The study aims to contribute significantly to the body of knowledge regarding the modified Dunn procedure as a reliable method for restoring hip function.

DOI: 10.1302/3114-251218

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