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Femoral Neck Non-Union - A Biomechanical Solution with Valgus Sliding Subtrochanteric Osteotomy: A Case Report
K H Teh1, J K Ruben2, C K Chan3
1Department of Orthopaedic Surgery, Universiti Putra Malaysia, Serdang, Malaysia.
Malaysian Orthopaedic Journal
|September 28, 2020
Summary
This study presents a successful sliding subtrochanteric osteotomy for treating femoral neck fracture non-union in a young patient. This technique offers a viable alternative to hip replacement for young, active individuals.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Bone Healing
Background:
- Avascular necrosis and non-union are significant complications following femoral neck fracture fixation.
- Hip replacement is a common solution but its long-term efficacy in young, high-demand patients is uncertain.
- Femoral head-preserving osteotomies are literature-supported alternatives for specific cases.
Observation:
- The conventional valgus subtrochanteric osteotomy involves lateral wedge resection.
- A simpler sliding oblique subtrochanteric osteotomy without wedge removal is an alternative technique.
- A case of non-union neck of femur fracture in a young gentleman was treated.
Findings:
- The described case successfully utilized a sliding subtrochanteric osteotomy.
- Fixation was achieved using a 135° dynamic hip screw (DHS) plate.
- This surgical approach demonstrated efficacy in treating non-union of the femoral neck.
Implications:
- Sliding subtrochanteric osteotomy is a potentially effective surgical option for young patients with femoral neck non-union.
- This technique may preserve the femoral head, offering a better long-term solution than hip replacement in select young populations.
- Further research into this technique could refine treatment protocols for complex femoral neck fractures.
