{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:22:09Z","timestamp":1787728929143,"version":"build-2784847793"},"reference-count":38,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Children's Orthopaedics"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The management of moderate and severe slipped capital femoral epiphysis is controversial. While in situ fixation is commonly used, the modified Dunn\u2019s 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\u2019s procedure or in situ fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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\u2019s procedure versus in situ fixation in patients with moderate or severe slipped capital femoral epiphysis were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of four studies were included in the final analysis. Modified Dunn\u2019s 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\u2019s procedure group, with a mean difference of \u221214.68 (p\u2009&lt;\u20090.00001) and \u221234.26\u2009degrees (p\u2009&lt;\u20090.00001), 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\u2009=\u20090.97).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Within the limits of our study, modified Dunn\u2019s 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\u2019s procedure, if done, be restricted to high-volume centers with low complication rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence:<\/jats:title>\n                    <jats:p>Level III\u2014Systematic review of Level III studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Prospero Registration No.:<\/jats:title>\n                    <jats:p>CRD42021279503.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18632521221078864","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T12:58:50Z","timestamp":1649163530000},"page":"27-34","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Is the modified Dunn\u2019s 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"],"prefix":"10.1177","volume":"16","author":[{"given":"Tim","family":"Cheok","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics, Alice Springs Hospital, Alice Springs, NT, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Alice Springs Hospital, Alice Springs, NT, Australia"},{"name":"College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Berman","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Alice Springs Hospital, Alice Springs, NT, 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Flinders Medical Centre, Bedford Park, SA, Australia"},{"name":"Department of Orthopaedic Surgery, Women\u2019s and Children\u2019s Hospital, North Adelaide, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Foster","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Alice Springs Hospital, Alice Springs, NT, Australia"},{"name":"Department of Orthopaedic Surgery, Flinders Medical Centre, Bedford Park, SA, Australia"},{"name":"Department of Orthopaedic Surgery, Women\u2019s and Children\u2019s Hospital, North Adelaide, SA, 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