An Evaluation of Treating Non-union of Femoral Neck Fractures with Valgus Angulation Osteotomy Using Sliding Hip Screws

Purpose: This study presents the outcomes of patients treated with DHS, following valgisation osteotomy, who had non-union after treatment for femoral neck fractures.Methods: The study retrospectively evaluated 16 patients who, between 2007 and 2014, developed pseudarthrosis following treatment for a femoral neck fracture and who were treated with DHS-osteosynthesis, after a valgus subtrochanteric osteotomy. Postoperative clinical evaluation of the patients was made using the Harris Hip Scoring (HHS) system. Results: Union of both the fracture and the osteotomy site was achieved in 17.2 weeks (range: 14-24 weeks) in all patients. The average Pauwels angle decreased from 72o (range 62–80) preoperatively to 26o (range 20–50) postoperatively. All patient’s fractures were Pauwels type III preoperatively and 4 type II and 12 type I postoperatively. The average HHS increased from 26 (range 18–34) preoperatively to 85 (range 68–94) postoperatively. Of the patients who were followed up for a mean duration of 3.1 years (range: 1-5 years), four had 1-cm shortening. No patient developed postoperative AVN of the femoral neck.Conclusions: For patients with non-union after femoral neck fracture, DHS-osteosynthesis after valgus osteotomy is a method with a shorter learning curve, which can be successfully performed