الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The management of SCFE has long been debated since its first description by Muller in 1889 (S M Khaladkar 2015). In-situ screw fixation is widely used in all cases as the standard of care and the prognosis depends on the degree of slip: good to excellent outcomes are expected in 94% to 96% of mild cases. However, a moderate or severe slip, as defined by Southwick and Loder et al, may result in femoroacetabular impingement, damage to the acetabular cartilage and the early onset of osteoarthritis (PV Samelis et al 2015). To correct the anatomical deformity in moderate to severe SCFE, several proximal femoral osteotomies have been described at the subcapital, basicervical, intertrochanteric and subtrochanteric levels. Osteonecrosis has been reported to occur at a rate of 10% to 100% following various operative approaches, and a combination of osteonecrosis and chondrolysis has been reported to develop in up to 42% of the patients. (PV Samelis, Papagrigorakis 2018)
A subcapital osteotomy, first explained by Dunn, at the level of the deformity, might be expected to function best biomechanically and to give the best prognosis. Unfortunately, it has been associated with a high rate of osteonecrosis of the femoral head, due to the vulnerability of the blood supply to the epiphysis. Safe surgical hip dislocation originally described by Ganz et al after studying the vascular anatomy of the femoral head, preserves the physeal blood supply and allows subcapital osteotomy with complete removal of the posterior callus, 100% correction of the slip angle and restoration of the normal anatomy (modified Dunn osteotomy). Moreover, the operating surgeon can see the posterosuperior retinaculum and control the tension in the end branches of the medial femoral circumflex artery within it. (T D Lerch et al. 2019)
The rationale of this study was to evaluate the functional and radiological outcomes of the anatomical reduction of a moderate or severe stable SCFE, using