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TREATMENT OF THE NONUNION OF THE FEMORAL NECK BY VALGUS OSTEOTOMY

Between 1980 and 1998, we performed 27 valgus osteotomies for nonunion of femoral neck fractures. Patients were aged 17 to 79, with an average of 45 years. Twenty-four patients had undergone previous surgery. Prior to osteotomy, the average neck-shaft angle was 105˚ (80 – 130˚), with an average shortening of 2.5 cm (1.5 – 4.5 cm). After valgus osteotomy, 24 of the 27 fractures healed after 3 – 10 months (average, 5 months). One patient died 2 months after surgery (79 years old) and two had implant failures. Five patients had mild avascular necrosis at the time of study, which was not symptomatic. Pain and limitation of motion improved remarkably, so that the majority of the patients did not have to use crutches. Shortening was reduced to an average of 1 cm. We recommend valgus osteotomy of the proximal femur in the nonunion of femoral neck fractures.