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ORIGINAL ARTICLE
Year : 2017  |  Volume : 52  |  Issue : 2  |  Page : 122-128

Subcapital reorientation for moderate and severe slipped capital femoral epiphysis: early results of Ain Shams University Hospitals


Department of Orthopedic surgery, Ain Shams University Hospital, Cairo, Egypt

Correspondence Address:
Mahmoud A Mahran
Ain Shams University, Medical School, Department of Orthopedic Surgery, Ahmed Lotfy Al-Sayed Street, Abbassia, Cairo 11341
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/eoj.eoj_28_17

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Background Subcapital reorientation for severe slipped capital femoral epiphysis offers the double benefit of immediate restoration of range of motion (ROM), limb length discrepancy (LLD), and long-term hip preservation from premature osteoarthrosis. Patients and methods Modified Dunn’s technique through safe surgical hip dislocation was performed in 12 adolescents who presented with moderate-to-severe slipped capital femoral epiphysis. There were 10 males and only two females, with a mean age of 15 years. The mean Southwick’s slip angle was 47°. Only two slips were clinically unstable. Results After a mean follow-up of 23 months, the mean α angle measured 37°, and the mean slip angle decreased to 4.7°. The mean hip flexion range was 104°; the mean internal rotation in flexion was 33°; and the mean external rotation in flexion was 34°. The mean Harris hip score at the latest follow-up was 99.6. None of the cases developed chondrolysis or osteonecrosis. Conclusion It has been a long-standing orthopedic myth, believed by many surgeons, that the capital epiphysis cannot be realigned for fear of avascular necrosis. On the basis of the present study, we believe that subcapital reorientation through safe surgical hip dislocation approach restores close to normal the proximal femoral anatomy, and thus, presumably, would offer good long-term outcomes for a condition that can have serious lifelong consequences on young adults.


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