Treatment of non-united femoral neck fracture by a novel subtrochanteric angulation lateral translation valgus osteotomy
- PDF / 947,746 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 108 Downloads / 174 Views
ORIGINAL PAPER
Treatment of non-united femoral neck fracture by a novel subtrochanteric angulation lateral translation valgus osteotomy (SALVA osteotomy) Mohamed Hegazy 1 & Naguib Basha 1 & Hassan Elbarbary 1 & Ebaa Mohamed Abdellatif Ali 2 & Ahmed Hosny Khalifa 3 & Mohamed Tageldeen Mohamed 1 & Nader M. Diab 1 & Abou Bakr Zein 1 & Ahmed Hazem Abdelazeem 1 & Khaled Fawaz 1 & Abdulla Mohamed Ahmed 1 & Ahmed Samir Barakat 1 Received: 18 November 2019 / Accepted: 4 March 2020 # SICOT aisbl 2020
Abstract Purpose The ideal treatment of non-united and neglected fracture neck femur in the young adult still remains unclear and is characterized by many biological and biomechanical challenges. Methods Twenty-one patients with non-united or neglected fracture neck femur aged between 19 and 50 years were treated by a novel subtrochanteric valgus osteotomy and were followed up for a mean of 26.7 months. Patients were assessed by radiological parameters, the Harris Hip Score, Oxford Knee Score, and Askin Bryan Criteria to categorize the overall outcome of the patients at 24 months. Other outcome measures included the occurrence of AVN, adductor lever arm, leg length discrepancy, and mechanical implant failure. Results All patients treated with the SALVA osteotomy consolidated and displayed a marked improvement of functional and radiological outcome measures. Nevertheless, there were 2 mechanical failures in patients with marked osteopenia and three developed AVN. Conclusions In patients with un-united/neglected fracture neck femur, SALVA osteotomy appears to be reliable and reproducible. It also restores the abductor lever arm and improves the leg length discrepancy. Technically less demanding conversion to arthroplasty remains still possible prospectively. Keywords Fracture neck femur . Non-union of neck femur fracture . Neglected neck femur fracture . Avascular necrosis (AVN) of head femur . Minimal clinically important difference (MCID) and minimal clinical important improvement (MCII) of the Harris Hip Score
Introduction
Level of Evidence: Level IV Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00264-020-04527-8) contains supplementary material, which is available to authorized users. * Ahmed Samir Barakat [email protected] 1
Orthopedics and Trauma Department, Cairo University, Cairo, Egypt
2
Helal Hospital, Cairo, Egypt
3
Klinik für Unfallchirurgie, Medizinische Hochschule, Hannover, Germany
Fractures of the neck of femur (NOF) are one of the most common reasons for hospital admission reaching up to 574 in Denmark per 100,000 population imposing a large burden on health care systems [1]. A universally accepted treatment of ununited or neglected neck of femur fractures has yet not been established due to the biological and biomechanical challenges of this entity. Nontreated fractures of the femoral neck for more than 30 days are regarded as neglected femoral neck fracture (NNF) [2]. As displaced fracture neck of femur (NOF) may cause disruption of the ascendin
Data Loading...
