الفهرس 
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Abstract
Slipped capital femoral epiphysis (SCFE) is relatively common in adolescents. Moderate to severe slipped capital femoral epiphysis leads to early osteoarthritis resulting from FAI. Impingement in SCFE has been associated with damage of the acetabular cartilage, which may explain early onset of osteoarthritis after SCFE. The management of SCFE has been controversial for decades, especially for moderate to severe slips. Historically long-term outcomes after in situ pinning, a lower surgical risk procedure, were successful for mild and moderate SCFE. It has been advocated by authors who believe in the remodeling potential of the deformed hip with some restoration of the disturbed anatomic axes.
Ganz described surgical hip dislocation to restore the normal anatomy, complete correction of the slip angle, and minimize the probability of cam-type FAI with preservation of physeal blood supply .
Out of 52 patients with slipped capital femoral epiphysis treated at our institution during the period from March 2017 to February 2020, only 15 patients fulfill our inclusion criteria and were treated by the modified dunn procedure, in this study we included 12 males and 3 females, the age of our patients ranged between 13-17 years, mean age was 15.2 years, we included 9 Rt hip, 6 Lt hip.
According to Fahey classifications 8 hips were chronic , and 6 hips were acute on top of chronic and only one hip was acute. According to Loder classification 10 cases were stable, while 5 cases were unstable. This study involves 6 cases with moderate slip ( slip angle ranged 30-500), and 9 cases with severe slip (slip angle more than 500 )
Regarding our results , the postoperative HHS was ranged from 60 to 100 with mean value 93.7. In stable cases (10 patients), it showed significant improvement in comparison to the preoperative scores with mean improvement was (26.1). Postoperative WOMAC was ranged from 0 to 20 with mean value 3.7 .In stable cases (10 patients), WOMAC score showed significant improvement in comparison to the preoperative scores with mean improvement was (79.6). Postoperative Heymann and Herndon score was assessed for all patients at 6 month follow up . In this study 8 patients were excellent, 5 patients were good ,2 patients was poor.
As regard postoperative complication, AVN were recorded in 2 patients out of the 15 patients included in this study. No patients developed deep infection, DVT, nerve injuries, implant failure, chondrolysis or non-union.
In conclusion , capital realignment through the modified dunn procedure is an effective and safe treatment option for moderate and severe SCFE in patients with open physes as it allows anatomical restoration of hip anatomy thus preventing FAI with its sequalae .This procedure is of no doubt atechnically demanding procedure that should only performed by well trained paediatric orthopaedic or adult hip surgeon. Though, our results demonstrated good functional and radiological short term outcome with low complication rate espechially in unstable SCFE . Our series had 7 patients with unstable slips(46.6%) who did not develop AVN at the latest follow-up.