The ideal management of an unstable slipped capital femoral epiphysis (SCFE) is still controversial. The currently available options are in-situ screw fixation with delayed corrective osteotomy, closed reduction and screw fixation and anatomic reduction by modified Dunn’s procedure (MDP). We present the results of our technique of controlled re-positioning (CRP) with primary osteoplasty in which the epiphysis is repositioned to the preacute slip stage and a mini-open osteoplasty is done in the same sitting to avoid later femoro-acetabular impingement. We had 27 unstable slips which presented to our institution between 2015 and 2019, of which nine were treated with the above technique, and the rest 18 were treated with MDP. All of them were followed up for a minimum of 1 year. The mean intraoperative flexion-internal rotation before osteoplasty was −21.1° (−5° to −40°), which improved to +22.8° (+15° to +30°). Pre- and post-operative mean head-neck angles were 46.5° and 18.3°, respectively, with a decrease of 28.2°. At the final follow-up, the mean alpha angle was 45.1° and the mean head-neck offset ratio was 0.26. None of the patients had avascular necrosis or chondrolysis. The technique of CRP, screw fixation and primary osteoplasty is a viable treatment option for a subset of patients with unstable SCFEs. But, the decision is made intraoperatively and the parents need to be counselled about the need for an alternative procedure if repositioning is unsuccessful. Level of evidence: level IV – case series.

不稳定的股骨头骨骺滑脱 (SCFE)的理想管理仍然存在争议。目前可用的选择是原位螺钉固定，延迟矫正截骨术，闭合复位螺钉固定和改良 Dunn 手术 (MDP) 的解剖复位。我们展示了我们的受控重新定位 (CRP) 技术与原发性骨成形术的结果，其中骨骺重新定位到急性滑脱阶段，并在同一个坐位中进行小型开放式骨成形术，以避免后来的股骨-髋臼撞击。我们有 27个不稳定的2015年至2019年提交给我院的单据，其中9人采用上述技术处理，其余18人采用MDP处理。所有这些都至少随访了 1 年。整骨术前平均术中屈曲内旋为-21.1°（-5°至-40°），改善至+22.8°（+15°至+30°）。术前和术后平均头颈角分别为46.5°和18.3°，减少了28.2°。在最后一次随访中，平均 α 角为 45.1°，平均头颈偏移比为 0.26。没有患者出现缺血性坏死或软骨溶解。CRP、螺钉固定和原发性骨成形术是部分不稳定患者的可行治疗选择SCFE。但是，该决定是在术中做出的，如果重新定位不成功，需要告知父母是否需要替代手术。证据级别：IV 级——案例系列。