Neglected intertrochanteric fractures treated with valgus osteotomy

Abstract

Introduction: Malunited intertrochanteric fractures may occur due to mechanical and biological factors. Malunion of intertrochanteric fractures is common in developing countries as many people rely on indigenous treatment and splint age for fractures. Varus malunion is more commonly seen as compared to valgus malunion. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomy-optimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. The double-angled 120° plate is usually used for internal fixation of the osteotomy. Material and methods: A total of 14 cases operated from May 2016 to December 2019. Outcomes analysed include radiological outcome in terms of improvement in neck-shaft angle and evidence of radiological union at the osteotomy site. Other outcomes analysed include, measurement of limb length discrepancy and functional outcome assessment with Oxford hip score. Results: There were significant improvements in the postoperative neck shaft angle and Oxford hip score. Limb length discrepancy improved to about 0.5 cms. Conclusion: Subtrochanteric lateral closing wedge valgus osteotomy and internal fixation with dynamic hip for maluniting intertrochanteric fracture showed good results.