Comparison of role of in-situ fixation and modified DUNN procedure in management of severe SCFE (Slipped Capital Femoral Epiphysis).

Abstract

Objective: To compare in-situ fixation and modified Dunn procedure in stable sever SCFE by assessing radiological and functional improvement as well as complication rates. Study Design: Retrospective Observational study. Setting: GTTH, Lahore. Period: 1^st September 2023 to 29^th February 2024. Methods: A total of 32 patients were included in the study. Sixteen patients constituted each management group. The radiologic assessment of these patients included calculation of alpha (α) angle on AP and lateral views, femoral head neck offset and Southwick angle both preoperatively and on the last follow-up. Functional assessment comprised of Heyman and Herndon classification on the last follow-up. Results: The comparison of degree of improvement achieved showed that significant higher improvement in AP α-angle, Lat α-angle, head-neck offset and Southwick angle (with p<0.001 for each parameter) was achieved in the Mod. Dunn procedure subgroup. As per Heyman and Herndon classification, excellent and good outcome were more commonly seen in the group treated by Modified Dunn procedure. Most of the cases in both the management groups had an uncomplicated course Conclusion: Hence it can be concluded that the Mod. Dunn procedure is way more efficacious than in-situ fixation in terms of radiologic deformity correction as well as subsequent functional gain. At the same time the complication profile lies within the safe margins.