Valgus angulation osteotomy in secondary treatment of femoral neck fractures

Fourteen patients who were operated on by various techniques for collum femoris fracture, between the years 1992 and 1998 were treated by valgus angulation osteotomy for non-union of the fracture. The average age of the patients was 45.2 years (range, 22–58 years). The osteotomy line was healed for all patients and the mean healing period was 3.6 months (range, 2.8 to 6.4 months). The nonunion of the femoral neck and the delay in uniting healed except for in one patient, and the healing period was found to be 5.8 months (range, 4.8–11 months). Including the 12 cases that had avascular necrosis at several preoperative degrees, five patients developed postoperative degenerative arthritis. During follow-ups, while the average score in the first year was 89.7, it was 85.7 in the last examination, accounting for 4% failure. For younger patients under the age of 60 who were treated with internal fixation, however nonunion, it is appropriate to perform angulation osteotomy, which is the rescuing operation, without regard to the feeding position of the head. We believe that this process will allow the union of the femoral head and, at most, lengthen the period for transition to prosthesis.