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We evaluated 121 patients who had had slipped capital femoral epiphysis (149 involved hips) twenty-one to forty-seven years after the diagnosis was made. The results were very good in most of the eighty-three hips with the slip left unreduced. Fifty-four hips that were treated by procedures designed to improve the alignment of the slipped femoral head had more complications and less favorable results, but in general, these were the more severe slips. However, there were enough slips of comparable severity that were treated unreduced to suggest that the long-term results, even in moderate and severe slips, were better after in situ fixation than after operative and manipulative treatment (as performed between 1915 and 1952). Twelve of the thirteen hips with acute slips were reduced (the thirteenth was one of the eighty-three unreduced hips) and aseptic necrosis developed in three, while nine had good results.