Surgical hip dislocation for anatomic reorientation of slipped capital femoral epiphysis

Controversies exist regarding the best treatment for slipped capital femoral epiphysis (SCFE). In fact, a variety of surgical procedures have been described and they can be divided into fixation in situ, compensatory osteotomies and direct corrections of the deformity at head-neck junction. The first and the second group of procedures have, so far, not gained optimal control over the risk of avascular necrosis or cannot achieve an anatomically aligned epiphysis with normal blood supply; on the contrary the third technique can achieve this target and prevent the residual pistol-grip deformity of the proximal femur, that can lead to anterior impingement, labral pathology, and the development of early hip arthritis. Open subcapital reorientation of the epiphysis by surgical dislocation has been described as a safe and effective technique in the recent literature. The small number of complications appears favorable considering the surgical complexity of the procedure. The purpose of this chapter is to attract other surgeons who have heard about and would like to know more details about this surgical technique.