Management of neglected femoral neck fracture in young adolescents with modified pauwels osteotomy

Abstract

Background: Non-union of the femoral neck fracture in young is difficult to tackle. Many reported treatment methods for neglected femoral neck fractures do not always satisfactorily address the problems like non-union,coxa vara, and limb shortening. If the femoral head is viable, the most appropriate treatment is valgus osteotomy, which increases the femoral neck angle to change shearing force to compression force. We prospectively reviewed the functional outcome of the modified Pauwels’ osteotomy in 16 young adults to determine whether this approach would correct those problems. Materials and Methods: A total of 16 cases of neck femur fracture in less than or equal to 16 year old neglected for more than 12 weeks were included in our study and were treated primarily by modified Pauwels intertrochanteric osteotomy with internal fixation. The patients were followed up to 12–24 months with radiography and were assessed regarding Harris hip score, unionand limb length discrepancy. Results: Union was seen in all the 16 patients .11 out of the 16 patients showed excellent clinical outcome (Harris hip score ≥ 90) with an average Harris score of 90.1 ± 6. Conclusion: Modified Pauwels’ Intertrochanteric Osteotomy is a safe and effective procedure in preserving the God gifted hip in neglected femoral neck fracture