scholarly journals Role of Valgus Osteotomy and Fixation with Double Angle Blade Plate in the Management of Neglected and Ununited Femoral Neck Fracture

2021 ◽  
Author(s):  
Hari Om Aggarwal ◽  
Amandeep Singh Bakshi ◽  
Harjit K Singh Chawla ◽  
Ayush Jain ◽  
Jaspreet Singh
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Young Patients ◽  
Valgus Osteotomy ◽  
Non Union ◽  
Neck Shaft Angle ◽  
Blade Plate ◽  
Neck Fracture ◽  
Angle Blade ◽  
Angle Blade Plate

Introduction: Femoral neck fracture non union in young patients is a challenging complication as joint replacement is not readily recommended and hip salvageable procedures are relatively unsatisfactory. Valgus intertrochanteric osteotomy described by Pauwels F is one of the treatment options for management of non union of femoral neck in young patients, which was later reciprocated by other surgeons. Aim: To assess the efficacy of valgus osteotomy and fixation with double angle blade plate in the management of neglected and ununited femoral neck fracture. Materials and Methods: This was a prospective cohort study, which included 30 patients of femoral neck fracture non union in whom intertrochanteric valgus osteotomy was performed and fixed with 120° double angled blade plate. The preoperative and postoperative neck-shaft angle was compared using the paired t-test. A p-value of <0.05 indicated statistically significant result. Results: There were 22 males (73.3%) and 8 females (26.7%). Mean age of patients was 35 years. Delay in presentation ranged from 8 weeks to 58 weeks (mean 24 weeks). By Pauwel’s classification, there were 13 Type II fractures and 17 Type III fractures. Mean follow- up was 18 months (12 to 36 months). The mean preoperative neck- shaft angle of 95° (range 80-110°) increased to 132° (range 120- 140°) after surgery. In all patients, there was improvement in leg length discrepancy after osteotomy. Femoral neck fractures united in 25 patients (83.3%). Conclusion: Valgus osteotomy and fixation with 120° double angle blade plate is a reliable method for treating non union femoral neck fracture in young adults. It provides rigid internal fixation and good results.

scholarly journals Modified Valgus Osteotomy for Treatment of Femoral Neck Fracture Non-Union

2012 ◽  
Vol 01 (03) ◽  
Author(s):  
Babak Siavashi ◽  
Mohammad Reza Golbakhsh ◽  
Dariush Gouran Savadkoohi
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Valgus Osteotomy ◽  
Non Union ◽  
Neck Fracture

scholarly journals Hip dislocation following the treatment of femoral neck fracture: Case report

2010 ◽  
Vol 138 (3-4) ◽  
pp. 248-251
Author(s):  
Zoran Vukasinovic ◽  
Igor Seslija ◽  
Borislav Dulic
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Open Reduction ◽  
Weight Bearing ◽  
Young Patients ◽  
Hip Dislocation ◽  
Full Weight Bearing ◽  
Limited Range Of Motion ◽  
Femoral Head Osteonecrosis ◽  
Neck Fracture

Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The patient had pains, and in clinical findings a shorter leg and limited range of motion in the hip - altogether 40 degrees. She was then successfully treated by open reduction, together with Chiari pelvic osteotomy and joint transfixation. Transfixation pin was removed three weeks following the operation. After that, the patient was put into the abduction device and physical therapy was started. The mentioned regimen lasted four months after the surgery, then the abduction device was removed and walking started. Full weight bearing was allowed eight months after surgery. Conclusion. As we have not found the literature data concerning the above mentioned problem, we solved it in the way that we usually do for the treatment of developmental dislocation of the hip in adolescence.

scholarly journals Impact of Cigarette Smoking on Re-operation and Revision Surgery after Femoral Neck Fracture Treatment

2020 ◽  
Vol 13 ◽  
pp. 195-201
Author(s):  
Mitchell Messner ◽  
Alexander Chong ◽  
Bruce Piatt
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Femoral Neck Fractures ◽  
Non Union ◽  
Initial Fixation ◽  
Neck Fracture ◽  
Group 3 ◽  
Former Smokers ◽  
Group 2 ◽  
Group 1

Introduction. Smokers and nicotine users have a higher risk of femoral neck fracture non-union and prolonged time to fracture union. The impact of smoking resulting in revision surgery after fixation of femoral neck fractures, however, rarely has been studied. The aim of this retrospective study was to review if cigarette smoking had an influence on re-operation and revision after femoral neck fracture treatment. Methods. Three groups of patients (Group 1: active smokers; Group 2: former smokers; and Group 3: non-smokers) who sustained a femoral neck fracture from January 2012 through August 2018 were included. Outcomes investigated included femoral neck fracture type, operative fixation type, fixation failure, and time interval between initial fixation and revision. Results. A total of 1,452 subjects were identified (Group 1: 165 subjects; Group 2: 507 subjects; and Group 3: 780 subjects). In the male population, Groups 1 and 2 had higher rates of femoral neck fracture than Group 3. Twelve cases required revisions (Group 1: three cases (6%); Group 2: two cases (2%); Group 3: seven cases (4%)), with all but one revision within the first year following initial fixation. Group 1 patients tended to be younger than the other two groups. Conclusion. Smoking has a positive association with the risk of femoral neck fracture amongst active and former male smokers. This study concluded that active smokers have a higher risk of non-union compared with non-smokers or former smokers. Smoking history, especially heavy or long-term, should play a role in deciding which fixation construct type to use for femoral neck fractures.

scholarly journals Serum albumin and fixation failure with cannulated hip screws in undisplaced intracapsular femoral neck fracture

2016 ◽  
Vol 98 (6) ◽  
pp. 376-379 ◽  
Author(s):  
O Riaz ◽  
R Arshad ◽  
S Nisar ◽  
R Vanker
Keyword(s):  
Femoral Neck ◽  
Serum Albumin ◽  
Femoral Neck Fracture ◽  
Femoral Neck Fractures ◽  
Fixation Failure ◽  
Non Union ◽  
Preoperative Serum ◽  
Neck Fracture ◽  
Posterior Tilt ◽  
Intracapsular Femoral Neck Fracture

Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%–19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed. Fixation failure was defined as a screw cut, avascular necrosis (AVN) or non-union. Results Of the patients, 185 were female and 66 male. The mean age was 77 years (range 60–101 years). Thirty seven (15%) patients had fixation failure: 10 (4%) due to AVN; 12 (5%) due to non-union; and 15 (6%) due to fixation collapse. Low serum albumin levels were significantly associated with failure (p=0.01), whereas gender (p=0.56), operated side (p=0.62), age (p=0.34) and screw configuration (p=0.42) were not. A posterior tilt angle greater than 20° on lateral radiography significantly predicted failure (p=0.002). Conclusions Preoperative serum albumin is an independent predictor of cannulated hip screw fixation failure in undisplaced femoral neck fractures. Nutritional status should therefore be considered when deciding between surgical fixation and arthroplasty to avoid the possibility of revision surgery, along with an increased risk of morbidity and mortality.

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