ReviewJournal of children's orthopaedics2022
Is the modified Dunn's procedure superior to in situ fixation? A systematic review and meta-analysis of comparative studies for management of moderate and severe slipped capital femoral epiphysis.
Review in Journal of children's orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Direct anterior approach for open correction of Slipped Capital Femoral Epiphysiolysis: surgical technique and clinical outcome.Journal of clinical orthopaedics and trauma · 2026Article
- Identification and management of unrecognized femoral head epiphysiolysis: a case report.Frontiers in pediatrics · 2026Article
- Comparison of Management Strategies and Associated Complications With Slipped Capital Femoral Epiphysis.Cureus · 2025Review
- Slipped capital femoral epiphysis in an Indigenous Australian population.Bone & joint open · 2025Article
- Subcapital realignment osteotomy for the treatment of moderate and severe slipped upper femoral epiphysis: A retrospective study of 123 hips in a tertiary center.Journal of children's orthopaedics · 2024Article
- A Delphi consensus study on the treatment of slipped capital femoral epiphysis: Considerable consensus in mild and moderate slips and limited consensus in severe slips.Journal of children's orthopaedics · 2023Article
- Capital Femoral Epiphysis with Acute Unstable Valgus Type Slip Managed with Closed Reduction and Percutaneous Fixation: A Case Report.Orthopedic research and reviews · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: The management of moderate and severe slipped capital femoral epiphysis is controversial. While in situ fixation is commonly used, the modified Dunn's procedure is increasingly popular within high-volume centers. We compared the clinical and radiological outcomes, as well as the rates of femoral head avascular necrosis or chondrolysis in patients managed with either modified Dunn's procedure or in situ fixation. Methods: A systematic search of the PubMed, Embase, The Cochrane Library, Science Direct, and Web of Science was performed in August 2021. Studies comparing outcomes and complications of modified Dunn's procedure versus in situ fixation in patients with moderate or severe slipped capital femoral epiphysis were included. Results: A total of four studies were included in the final analysis. Modified Dunn's procedure did not result in improved clinical outcomes. However, radiological outcomes as measured using Southwick angles and Alpha angles were significantly improved in the modified Dunn's procedure group, with a mean difference of -14.68 (p < 0.00001) and -34.26 degrees (p < 0.00001), respectively, compared to in situ fixation. There was no difference in the odds of femoral head avascular necrosis or chondrolysis, with odds ratio of 0.99 (p = 0.97). Conclusion: Within the limits of our study, modified Dunn's procedure did not improve clinical outcomes. There were significantly improved radiological outcomes without higher odds of femoral head avascular necrosis or chondrolysis. Further long-term studies are required to better guide management of moderate and severe slipped capital femoral epiphysis, especially in unstable slips. In the meantime, we recommend that the modified Dunn's procedure, if done, be restricted to high-volume centers with low complication rates. Level of evidence: Level III-Systematic review of Level III studies. Prospero Registration No: CRD42021279503.
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