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General Orthopaedics

RESULTS OF MODIFIED DUNN PROCEDURE WITH RETINACULAR DISSECTION IN VALGUS-TYPE SLIPPED FEMORAL CAPITAL EPIPHYSIS

The International Society for Technology in Arthroplasty (ISTA), 30th Annual Congress, Seoul, South Korea, September 2017. Part 2 of 2.



Abstract

Introduction

In situ pinning for classic slipped capital femoral epiphysis(SLIP) is evolving to a more direct and anatomic realignment of proximal femoral epiphysis; but in no study the result of such a treatment in Valgus Slip, an uncommon type of slipped capital femoral epiphysis, has been reported.

Material and methods

Three hips in three patients (one male, two female) with valgus SCFE were treated by sub-capital realignment (two hips) or femoral neck osteotomy (one hip) for anatomic realignment of proximal femoral epiphysis. Extended retinacular flap technique performed through surgical hip dislocation in all hips. They followed clinically by Merle d'Aubigne Scale and visual analog scale for pain and radiographically for AVN, recurrence of SLIP, chondrolysis and osteoarthritis

Result

The age of the patients was 10,11 and 18 years. In all hips the neck-shaft angle was increased.18 years old male had bilateral chronic valgus SLIP with severe retro tilt of the head over the neck and bilateral acetabular dysplasia.11 years old girl with an acute valgus SLIP also had bilateral acetabular dysplasia and in 10 years old girl only one hip presented with acute on chronic valgus SLIP. All had severe displacement. The mean preoperative epiphyseal shaft angle (ESA) of 107.5° (range 85–125°) was reduced to 60° (range 55–70°) postoperatively. mean Merle d'Aubigne Scale was 16 and radiographically complete union and good alignment achieved without any complication.

Conclusion

Anatomical realignment of proximal femoral epiphysis in this small series of patient with valgus type SCFE had good to excellent results.


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