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Valgus intertrochanteric osteotomy for femur neck pseudoarthrosis: a simple solution to a complex problem that has stood the test of time

  • Ashok S. GavaskarEmail author
  • Parthasarathy Srinivasan
  • Balamurugan Jeyakumar
  • Rufus V. Raj
Review Article
  • 17 Downloads

Abstract

Femoral neck nonunion in young patients has always been a difficult problem to deal with for surgeons. Numerous surgical procedures to address either the biological or mechanical issues at the nonunion have been described and most of them have been associated with variable results. Isolated biological augmentation is often associated with poor results and some techniques like vascularized grafting may require not so commonly available expertise. Valgus osteotomy is aimed to correct the abnormal fracture biomechanics associated with femoral neck fractures. By altering the nature of force transmission across the nonunion, shear forces are converted into compressive forces that lead to rapid osseous union without the need for bone grafting. Though the principles are sound and were described a long time ago, the technical aspects have evolved over time. Various modifications have been described to overcome shortcomings such as limb length discrepancy, reduction of femoral offset, alteration in mechanical axis, and the overall proximal femur anatomy. In this review, we look back at the fundamental principles and recent literature on the results of valgus intertrochanteric osteotomy for femoral neck pseudoarthrosis. We also highlight the important need for accurate preoperative planning and surgical execution. Lastly, we elaborate on the technical improvisations that have happened over time in order to improve functional results and to minimize complications and poor outcome after a valgus osteotomy.

Keywords

Valgus intertrochanteric osteotomy Pseudoarthrosis Femur neck fracture 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  • Ashok S. Gavaskar
    • 1
    Email author
  • Parthasarathy Srinivasan
    • 1
  • Balamurugan Jeyakumar
    • 1
  • Rufus V. Raj
    • 1
  1. 1.Rela Institute of OrthopedicsDr. Rela Institute & Medical CentreChennaiIndia

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