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During an eight-year period, twenty-four Southwick osteotomies were performed in twenty-one patients with severe chronic slipped capital femoral epiphysis. After follow-ups ranging from two to ten years (average, four and one-half years), correction of the deformity had been maintained in all but one patient, who has loss of fixation of the osteotomy. One patient had joint-space narrowing, avascular necrosis of the femoral head, and significant restriction of motion which was still present three years after operation. We concluded that this osteotomy gives good correction of the deformity but is a major operative procedure that should be recommended only for severe, chronic slips. Preoperative loss of motion and joint-space narrowing are probably contraindications for the procedure, particularly in black patients.