Intertrochanteric osteotomy-a salvage procedure-in non-union of the femoral neck

ABSTRACT

A series of 22 patients with ununited femoral neck fractures were treated by a Pauwels intertrochanteric abduction osteotomy. All the patients were under 60 years of age, Bone scan was done for all patients before the surgery. Six of them showed radiological evidence of avascular femoral head necrosis before osteotomy, and 10 non-unions showd associated varus deformity. The average follow up was 3.6 years [range from 1.8 to 5.1 years]. Sixteen cases were consolidated without complications [72.7%] and six cases necessitated further surgical interference. We concluded that in young active patients under 60 years with ununited femoral neck fractures, intertrochanteric osteotomy provided a high proportion of good results even in the presence of avascular necrosis of the head provided that there has been no collapse. If osteotomy fails, prosthetic replacement is still possible