Role of Valgus Osteotomy and Fixation with Double Angle Blade Plate in the Management of Neglected and Ununited Femoral Neck Fracture
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 fo...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2021-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/15169/44597_CE[Ra1]_F[SK]%20GC(AnK)_PF1(JM_OM)_PFA(JY_AnK)_PN(KM).pdf |
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| author | Hari Om Aggarwal Amandeep Singh Baks Harjit K Singh Chawla Ayush Jain Jaspreet Singh |
| author_facet | Hari Om Aggarwal Amandeep Singh Baks Harjit K Singh Chawla Ayush Jain Jaspreet Singh |
| author_sort | Hari Om Aggarwal |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T13:09:52Z |
| format | Article |
| id | doaj.art-635e342dc16f474a8e26f0331f5ee406 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-22T13:09:52Z |
| publishDate | 2021-07-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-635e342dc16f474a8e26f0331f5ee4062022-12-21T18:24:46ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-07-011507081110.7860/JCDR/2021/44597.15169Role of Valgus Osteotomy and Fixation with Double Angle Blade Plate in the Management of Neglected and Ununited Femoral Neck FractureHari Om Aggarwal0Amandeep Singh Baks1Harjit K Singh Chawla2Ayush Jain3Jaspreet Singh4Associate Professor, Department of Orthopaedics, Government Medical College, Patiala, Punjab, IndiaAssociate Professor, Department of Orthopaedics, Government Medical College, Patiala, Punjab, IndiaAssistant Professor, Department of Orthopaedics, Government Medical College, Patiala, Punjab, India.Senior Resident, Department of Orthopaedics, Government Medical College, Patiala, Punjab, IndiaAssistant Professor, Department of Orthopaedics, Government Medical College, Patiala, Punjab, IndiaIntroduction: 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.https://jcdr.net/articles/PDF/15169/44597_CE[Ra1]_F[SK]%20GC(AnK)_PF1(JM_OM)_PFA(JY_AnK)_PN(KM).pdfinternal fixationintertrochanteric osteotomykirschner wiresneck-shaft angle |
| spellingShingle | Hari Om Aggarwal Amandeep Singh Baks Harjit K Singh Chawla Ayush Jain Jaspreet Singh Role of Valgus Osteotomy and Fixation with Double Angle Blade Plate in the Management of Neglected and Ununited Femoral Neck Fracture Journal of Clinical and Diagnostic Research internal fixation intertrochanteric osteotomy kirschner wires neck-shaft angle |
| title | Role of Valgus Osteotomy and Fixation with Double Angle Blade Plate in the Management of Neglected and Ununited Femoral Neck Fracture |
| title_full | Role of Valgus Osteotomy and Fixation with Double Angle Blade Plate in the Management of Neglected and Ununited Femoral Neck Fracture |
| title_fullStr | Role of Valgus Osteotomy and Fixation with Double Angle Blade Plate in the Management of Neglected and Ununited Femoral Neck Fracture |
| title_full_unstemmed | Role of Valgus Osteotomy and Fixation with Double Angle Blade Plate in the Management of Neglected and Ununited Femoral Neck Fracture |
| title_short | Role of Valgus Osteotomy and Fixation with Double Angle Blade Plate in the Management of Neglected and Ununited Femoral Neck Fracture |
| title_sort | role of valgus osteotomy and fixation with double angle blade plate in the management of neglected and ununited femoral neck fracture |
| topic | internal fixation intertrochanteric osteotomy kirschner wires neck-shaft angle |
| url | https://jcdr.net/articles/PDF/15169/44597_CE[Ra1]_F[SK]%20GC(AnK)_PF1(JM_OM)_PFA(JY_AnK)_PN(KM).pdf |
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