Intertrochanteric osteotomy for non-union of the femoral neck.
We report a series of 50 patients under 70 years of age who had an ununited femoral neck fracture treated by a Pauwels abduction osteotomy. At an average follow-up of 7.1 years, seven patients had required prosthetic replacement and 37 others were reviewed in detail. In these patients the Harris hip score averaged 91. Twenty-two hips showed radiographic evidence of avascular femoral head necrosis, but only three of these had been replaced. For active patients with non-union of a femoral neck fracture, Pauwels osteotomy provides a high proportion of good results even in the presence of avascular necrosis of the head, providing there has been no collapse. If osteotomy fails, prosthetic replacement is still possible.
Marti
R K
RK
Department of Orthopaedic Surgery, University of Amsterdam, The Netherlands.
Schüller
H M
HM
Raaymakers
E L
EL
D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012086:Reoperation