Current studentsExisting staffContact us
 

Indices affecting outcome of neglected femoral neck fractures after valgus intertrochanteric osteotomy

Simple item page
dc.contributor.authorVarghese, V.
dc.contributor.authorRamasamy, B.
dc.contributor.authorTitus, V.
dc.contributor.authorOommen, A.
dc.contributor.authorJepegnanam, T.
dc.date.issued2014
dc.description.abstractObjectives: To evaluate preoperative neck resorption and postoperative valgus orientation as predictors of union and functional outcome after valgus intertrochanteric osteotomy for treatment of neglected femoral neck fractures and nonunions. Design: Retrospective cohort study. Setting: Tertiary care center. Patients/Participants: Forty consecutive patients with neglected femoral neck fracture and nonunions were treated with valgus intertrochanteric osteotomy, and follow-up was available in 32 patients (average age, 43 years; range, 14–60 years; average nonunion duration, 6 6 7 months; range, 1–36 months). Intervention: Valgus intertrochanteric osteotomy. Main Outcome Measurements: Clinical outcome was assessed with Harris hip score. Plain radiographs were evaluated for union, avascular necrosis, preoperative bone deficiency (neck resorption ratio), and postoperative femoral head fragment alignment (head-shaft angle). Results: Follow-up at 5 6 3 years (range, 2–12 years) after surgery showed union in 29 patients (91%), and Harris hip score was 82 6 13 points (range, 63–100 points). The 3 patients with persistent nonunion at the neck of femur had neck resorption ratio ,0.52. Increased postoperative head-shaft angle was associated with lower follow-up Harris hip score; postoperative valgus alignment .15 degrees compared with the contralateral side was associated with poor functional outcome. The presence of avascular necrosis did not affect the outcome. Conclusions: Valgus intertrochanteric osteotomy resulted in union and satisfactory functional outcome in most patients who had neglected femoral neck fractures and nonunions. Preoperative neck resorption ratio ,0.5 was a risk factor for nonunion, and excessive valgus alignment was a risk factor for poor functional outcome after osteotomy.
dc.description.statementofresponsibilityViju D. Varghese, Palapattu R. Boopalan, Vijay T.K. Titus, Anil T. Oommen, and Thilak S. Jepegnanam
dc.identifier.citationJournal of Orthopaedic Trauma, 2014; 28(7):410-416
dc.identifier.doi10.1097/BOT.0000000000000030
dc.identifier.issn0890-5339
dc.identifier.issn1531-2291
dc.identifier.orcidRamasamy, B. [0000-0003-2708-8420]
dc.identifier.urihttp://hdl.handle.net/2440/86693
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.rights© 2013 Lippincott Williams & Wilkins
dc.source.urihttps://doi.org/10.1097/bot.0000000000000030
dc.subjectHip; valgus osteotomy; nonunion femoral neck; functional outcome
dc.titleIndices affecting outcome of neglected femoral neck fractures after valgus intertrochanteric osteotomy
dc.typeJournal article
pubs.publication-statusPublished

Files

Collections

Orthopaedics and Trauma publications