Dunns osteotomy surgical technique
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Severe grade II/III unstable slipped upper femoral epiphysis (SUFE/SCFE) is associated with high rates of avascular necrosis (AVN). Historically rates as high as 50% have been quoted. In view of this there has been a tendency to perform the simplest and (perceived) least risky operation. This is generally held to be pinning in situ.
The Dunn osteotomy was described for stable and unstable SUFE. The osteotomy is performed at the level of the physis. Subsequent authors generally failed to match the results of the original author. However, the advent of the trochanteric flip osteotomy and extended reticular flaps as described by Ganz has reignited interest and the ‘modified’ Dunn osteotomy has had encouraging results in the hands of high volume surgeons.
The classic modified Dunn osteotomy requires division of the ligament trees and dislocation of the femoral head. We describe an alternative method where by the femoral head is not dislocated and the ligamentum trees is preserved.
Author: Mr Christopher Edward Bache FRCS(Tr & Orth)
Institution:The Birmingham Childrens’ Hospital
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
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- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
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The pass mark is 75%.
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- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
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