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Satisfactory functional outcomes experienced after valgus intertrochanteric osteotomy
Most patients who neglected femoral neck fractures and nonunions experienced union and satisfactory functional outcome with valgus intertrochanteric osteotomy, according to study results.
Researchers retrospectively reviewed radiographs and medical records for 40 consecutive patients with neglected femoral neck fracture and nonunions treated with valgus intertrochanteric osteotomy from 1998 to 2008. Harris Hip Score was used to assess clinical outcomes, and plain radiographs were evaluated for union, avascular necrosis, preoperative bone deficiency and postoperative femoral head fragment alignment.
Data were available for 32 patients at 5-year follow-up. Ninety-one percent of patients showed union, and postoperative Harris Hip Score was 82 points.
The researchers found a neck resorption ratio of less than 0.52 among three patients with persistent nonunion at the neck of femur. An association between increased postoperative head-shaft angle and lower follow-up Harris Hip Score was discovered. Additionally, a postoperative valgus alignment of greater than 15° was associated with poor functional outcome compared with the contralateral side, according to the researchers.
The outcome was not affected by the presence of avascular necrosis.
Disclosure: The authors have no relevant financial disclosures.