Sistema Ortopédico e Muscular: Pesquisa Atual
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Modified Valgus Osteotomy for Treatment of Femoral Neck Fracture Non-Union

Babak Siavashi, Mohammad Reza Golbakhsh and Dariush Gouran Savadkoohi

Background: Non-union of the femoral neck fracture in young and middle-aged patients is a problem and can be very debilitating. If the femoral head is viable, the most appropriate treatment is valgus osteotomy that without refreshing of the fracture site, it only increases the femoral neck angle to change shearing force to compression force. In this study, after refreshing the non-union site and establishing normal relation between head and neck of the femur, valgus osteotomy was done.
Materials and methods: In this case-series study, of all patients who had femoral neck non-union and presented during a 2-year period to Sina Hospital and were less than 60 years of age with a viable femoral head, 22 patients (18 males and 4 females) with a mean age of 34 years (20-47 years) were studied. There were stabilizing screws in 10 patients. The patients were followed up to one year with radiography and were assessed regarding Harris hip score, union, and complications especially femoral head necrosis and the signs of joint destruction and arthrosis.
Results: Harris hip scores before and after surgery was 63 and 89, respectively. The angle between the femoral neck and shaft of the femur reached 150 degrees and union was occurred in all patients. Femoral head necrosis happened in 2 cases and in 3 cases following femoral neck collapse, implant tip was entered into the joint which was removed immediately. Mean time of union was 4.5 months.
Conclusion: Refreshing the non-union site before valgus osteotomy in femoral neck fracture non-union causes increase in union and less complications.