Unstable recent intracapsular femoral neck fractures in young adults: osteosynthesis and primary valgus osteotomy using broad dynamic compression plate.
BACKGROUND
Displaced intracapsular femoral neck fractures continue to be a difficult problem to treat. Various treatment modalities and their modifications have been proposed to improve the outcome. Osteosynthesis and primary valgus angulation osteotomy is one of them. Technique and outcome in a consecutive series of recent intracapsular femoral neck fractures in young adults, from a single center, is presented.


METHODS
Fifty-five patients of recent (<3 weeks old) displaced intracapsular fracture neck femur (Garden III and IV, Pauwels III, with or without comminution) in the age group 20-50 years (mean 35.4+/-10.4 years) were subjected to osteosynthesis and primary valgus intertrochanteric osteotomy using contoured broad dynamic compression plate (DCP). The patients were followed up from two to six years (mean 4.6 years).


RESULTS
Fifty-one fractures united by six months of the index procedure (92.7% union range). Avascular necrosis (AVN) developed in six patients (11%). The other complications were shortening (six), coxa vara (two), infection (two) and delayed union at osteotomy site (one). Excellent results were achieved in 48, good/fair in four and poor in three patients.


CONCLUSIONS
Osteosynthesis with cancellous screw and primary valgus intertrochanteric osteotomy stabilized by a contoured broad DCP is a simple, easy to perform, biological treatment. Failure in a particular case can be treated with any appropriate second procedure.


METHODS
IV.
Singh
M P
MP
Department of Orthopedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi - 110 095, India.
Aggarwal
Aditya N
AN
Arora
Anil
A
Dhammi
Ish K
IK
Singh
Jagjit
J