Management of neglected femoral neck fractures and nonunions using a novel triple surgery combination: an Indian experience.

Abstract

This study describes a 2- to 13-year follow-up of a novel technique for osteosynthesis of neglected femoral neck fractures and nonunions that combines internal fixation with the benefits of fibular grafting and valgus angulation osteotomy. Twenty-three patients were treated by the "3-in-1" surgery, which consisted of osteosynthesis with a dynamic hip screw, nonvascularized fibular grafting, and valgus osteotomy, between January 1996 and June 2009. Union was achieved in all patients at an average of 5.4 months. The average shortening was 0.9 cm. Although avascular necrosis was seen in 4 patients, 2 of them still had good functional scores. Excellent and good hip functional scores were seen in 18 patients. Well-executed surgeries combining biomechanics and biology can ensure union in neglected femoral neck fractures and nonunions provided an adequate length of the neck and proximal fragment is present and there is no subchondral collapse.

• Authors: Amit Kapoor, Lakshmi Venkatesh Deety, Vinith Zachariah John, Sathish Devadoss, A Devadoss
• Journal: The international journal of lower extremity wounds (Int J Low Extrem Wounds) Vol. 11 Issue 1 Pg. 49-58 (Mar 2012) ISSN: 1552-6941 [Electronic] United States
• PMID: 22334596 (Publication Type: Journal Article)

Topics

• Adult
• Bone Screws
• Female
• Femoral Neck Fractures (diagnosis, surgery)
• Femur Neck (injuries, surgery)
• Fracture Fixation, Internal (instrumentation, methods)
• Fractures, Malunited
• Humans
• India
• Male
• Middle Aged
• Prospective Studies
• Treatment Failure
• Young Adult