Multicenter retrospective study of 27 adolescents with unstable SCFE (Loder criteria) treated with the modified Dunn procedure by 5 fellowship-trained pediatric orthopedic surgeons across separate tertiary-care institutions. Asks whether the excellent outcomes from the originating center can be reproduced — and at what complication cost.
When planning a modified Dunn for unstable SCFE, counsel families that even in expert hands the osteonecrosis rate is ~26% and implant failure ~15% — and osteonecrosis, not the slip itself, is the dominant driver of poor long-term function.
If smaller screws or K-wires are used for epiphyseal fixation, have a low threshold to revise to ≥6.5-mm cannulated screws, as all hardware failures in this series involved smaller implants.
Multicenter retrospective study of 27 adolescents with unstable SCFE (Loder criteria) treated with the modified Dunn procedure by 5 fellowship-trained pediatric orthopedic surgeons across separate tertiary-care institutions. Asks whether the excellent outcomes from the originating center can be reproduced — and at what complication cost.
When planning a modified Dunn for unstable SCFE, counsel families that even in expert hands the osteonecrosis rate is ~26% and implant failure ~15% — and osteonecrosis, not the slip itself, is the dominant driver of poor long-term function.
If smaller screws or K-wires are used for epiphyseal fixation, have a low threshold to revise to ≥6.5-mm cannulated screws, as all hardware failures in this series involved smaller implants.