title: Femoral neck non-union treatment by valgus intertrochanteric osteotomy.
abstract: OBJECTIVE
  : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union.
  
  
  METHODS
  : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated.
  
  
  RESULTS
  : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis).
  
  
  CONCLUSIONS
  : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study.
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Santa Casa de Misericórdia de Porto Alegre, Ortopedia e Traumatologia, Porto Alegre, RS, Brasil.
authors.forename: Carlos Roberto
authors.initials: CR
authors.lastname: Schwartsmann
authors.affiliation: Santa Casa de Misericórdia de Porto Alegre, Departamento de Ortopedia e Traumatologia, Cirurgia do Quadril, Porto Alegre, RS, Brazil.
authors.forename: Leandro de Freitas
authors.initials: Lde F
authors.lastname: Spinelli
authors.affiliation: Santa Casa de Misericórdia de Porto Alegre, Departamento de Ortopedia e Traumatologia, Cirurgia do Quadril, Porto Alegre, RS, Brazil.
authors.forename: Anthony Kerbes
authors.initials: AK
authors.lastname: Yépez
authors.affiliation: Santa Casa de Misericórdia de Porto Alegre, Departamento de Ortopedia e Traumatologia, Cirurgia do Quadril, Porto Alegre, RS, Brazil.
authors.forename: Leonardo Carbonera
authors.initials: LC
authors.lastname: Boschin
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Fisioterapia, Porto Alegre, RS, Brasil.
authors.forename: Marcelo Faria
authors.initials: MF
authors.lastname: Silva
keywords: Femoral neck fractures; Hip/surgery.; Osteotomy