Nonunion of femoral neck fracture and trochanteric osteotomy after a pinned, slipped capital femoral epiphysis: a case report.

Femoral neck fracture as a complication of slipped capital femoral epiphysis (SCFE) is rare. Even rarer is a femoral neck nonunion as an additional complication. This is the first case reported in the literature of a failed valgus osteotomy for a femoral neck nonunion. A salvage operation involving a step-cut valgus/flexion/internal rotation osteotomy, open reduction and internal fixation, with a blade plate and cannulated screw, placement of an allograft femoral strut, and allograft bone grafting was successfully performed. Femoral neck fractures following SCFE fixation are more difficult to treat because of abnormal femoral neck configuration. Therefore a valgus, flexion, and internal rotation producing osteotomy may need to be initially performed to prevent a femoral neck nonunion.