Valgus Inter-trochanteric Osteotomy for Management of Neglected Fracture Neck of Femur in Young Adults: A Simplified Operative Technique
Journal Title: Journal of Orthopaedic Education - Year 2019, Vol 5, Issue 1
Abstract
Introduction: Neglected fracture neck of femur in young adults has high rate of non-union, avascular necrosis (AVN) and secondary arthrosis. Only stable fixation is under surgeon`s control as other complications are part & parcel of injury itself. We achieved hip preservation with a simplified operative technique of valgus inter-trochanteric osteotomy fixed with 120 degrees double angled barrel plate and cancellous screws. Objectives: To develop an easily reproducible surgical technique with stable fixation to convert high grade pauwel fractures to low grade leading to hip preservation in majority of young adults & delay the need for future arthroplasty. Materials and Methods: 18 cases of Neglected fracture neck of femur (>3 weeks) in young adults (<50 yr) were operated using the simplified technique and followed from June 2016 to April 2018. Average presentation was 37 days from injury & average follow-up of 10.4 months. Radiological parameters analyzed were fixation and union at osteotomy and fracture site. Functional outcomes were assessed using modified Askin & Bryan Criteria. Results: Out of 18 cases, Good (9) to Excellent (6) results were seen in 15. 3 had fair outcomes necessitating replacement arthroplasty. AVN was seen in 5 cases and non-union at fracture site in 3 cases. Osteotomy united in all cases. No implant failure was encountered. 13 were able to perform activities of daily living satisfactorily and showed no signs of AVN till last follow-up. Conclusion: The simplified technique offers good results in majority of young adults with neglected fractures neck of femur with minimal complication rates.
Authors and Affiliations
Naval Bhatia
Keywords
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- EP ID EP647047
- DOI 10.21088/joe.2454.7956.5119.8
- Views 96
- Downloads 0
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