Teh K H, Ruben J K, Chan C K, Abbas A A
Department of Orthopaedic Surgery, Universiti Putra Malaysia, Serdang, Malaysia.
Department of Orthopaedic Surgery, Hospital Serdang, Kajang, Malaysia.
Malays Orthop J. 2020 Jul;14(2):134-137. doi: 10.5704/MOJ.2007.022.
Avascular necrosis and non-union are two most dreaded complications of femoral neck fracture fixations. Hip replacement seems to be a simple solution for this complex problem. However, the long-term efficacy of prosthetic replacement in the young population with higher functional demand is still questionable. Femoral head preserving valgus subtrochanteric osteotomies in properly selected cases have strong support from literature. The conventional technique of valgus subtrochanteric osteotomy involves lateral based wedge resection. Alternatively, a simpler sliding oblique subtrochanteric osteotomy without any wedge removal can also be performed. We hereby describe a successful case of sliding subtrochanteric osteotomy with 135° dynamic hip screw (DHS) plate fixation in treating non-union neck of femur fracture in a young gentleman.
股骨头缺血性坏死和骨不连是股骨颈骨折内固定最可怕的两种并发症。髋关节置换似乎是解决这个复杂问题的一个简单办法。然而,对于功能需求较高的年轻人群,假体置换的长期疗效仍存在疑问。在适当选择的病例中,保留股骨头的转子下外翻截骨术有充分的文献支持。传统的转子下外翻截骨技术包括基于外侧的楔形切除。另外,也可以进行一种更简单的不切除任何楔形骨块的滑动斜行转子下截骨术。在此,我们描述一例采用135°动力髋螺钉(DHS)钢板固定的滑动转子下截骨术成功治疗一名年轻男性股骨颈骨折骨不连的病例。