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DOI: 10.1055/s-0041-1732391
Long-Term Outcome of Valgus Osteotomy and Fixation with Double Angled Dynamic Hip Screw for Nonunion Fracture of the Neck of the Femur in Young Adults
Article in several languages: português | English
Abstract
Objective To evaluate the long-term results of valgus intertrochanteric osteotomy fixed with double angled dynamic hip screw for nonunion fracture of the neck of the femur in young adults. This implant allows more freedom of fixation in the sagittal plane. Very few studies have evaluated the long-term outcome for treatment of nonunion in fractures of the neck of the femur.
Methods This is a prospective interventional study that included 20 patients with nonunion of the fracture of the neck of the femur aged < 60 years old without avascular necrosis of the head and significant resorption of the neck of the femur. A lateral closing wedge osteotomy was performed just above the lesser trochanter after inserting the Richard screw across the nonunion site, and it was fixed with a double-angle 120° barrel plate. The outcome was evaluated using union rate and the Harris Hip Score for functional outcome.
Results The average postoperative decrease in the Pauwels angle was of 28.9°. A total of 80% of the cases progressed to union within a mean duration of 7.53 months. The mean Harris Hip Score at the final follow-up was 86.45.
Conclusion Valgus intertrochanteric osteotomy and fixation with a double angled dynamic hip screw is a reliable and effective method for preservation of head and promoting union in an ununited fractured neck of the femur in young patients.
Contribution of the Authors
Sharma A. and Gupta S. were responsible for the conception and design of the study. Data acquisition was done by Sharma A., Gupta S. and Patil B.. Data analysis and interpretation was done Kansay R. and Gupta S.. Drafting of the article was done by Sharma A. and Patil B.. Critical revision was done by Gupta S.and Kansay R.. All authors have approved the final version of the manuscript.
Financial Support
There was no financial support from public, commercial, or non-profit sources.
Work developed at Department of Orthopedics, Govt. Medical College and Hospital, Chandigarh, India
Publication History
Received: 01 December 2020
Accepted: 08 March 2021
Article published online:
01 June 2022
© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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