title: Late correction of neck deformity in healed severe slipped capital femoral epiphysis: short-term clinical outcomes.
abstract: OBJECTIVE
  Contemporary methods for the management of neck deformity following a healed severe slipped capital femoral epiphysis (SCFE) include subcapital neck osteotomy.
  
  
  METHODS
  18 patients with chronic severe SCFE in the oblique plane (mean slip angle = 70°) constituted the study group. 6 patients with an open physis underwent modified Dunn capital realignment and 12 patients with a closed physis underwent surgical dislocation with a corrective neck osteotomy. 10 patients already had an in-situ pinning.
  
  
  RESULTS
  The mean follow-up was 4.5 years (3-6 years). The mean preoperative modified Harris Hip Score (mHHS) and nonarthritic hip score (NAHS) were 24 and 40 respectively, followed by a score of 89 and 92 respectively at the last follow-up (p = 0.0002). Radiologically, all the parameters showed a significant correction. The mean pre- and postoperative values of alpha angle were 79.8 and 34.5 respectively (p = 0.0002); AP slip angle being 36.7 and 14.8 (p = 0.002); lateral slip angle being 54.2 and 13.6 (p = 0.0002); oblique plane slip angle being 70.7 and 20.8 (p = 0.0002) and centre trochanter distance being -6.9 and 1.2 (p = 0.002). The major complications seen were nonunion of the neck osteotomy (n = 1/12) and chondrolysis (n = 1/6) in the modified Dunn's group. The overall complication rate was 11%. There was no statistically significant difference in outcome between the 2 groups clinically and radiologically.
  
  
  CONCLUSIONS
  Femoral neck osteotomy is a potentially rewarding technique to correct severe neck deformities and restoring hip function in the short term.
authors.affiliation: Centre for Hip Preservation, Sheffield Children's Hospital and Doncaster Royal Infirmary, Sheffield - UK.
authors.forename: Balasubramanian
authors.initials: B
authors.lastname: Balakumar
authors.affiliation: Centre for Hip Preservation, Sheffield Children's Hospital and Doncaster Royal Infirmary, Sheffield - UK.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Madan
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D005260:Female; D005272:Femur Neck / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D060048:Slipped Capital Femoral Epiphyses / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult