Chakrapani Arjun S, Ragate Rahul, Shaik Arfaz, Thusoo Varun, Singh Mukul Kumar, Nair Abhishek, Kumar Amnish, Jadav Ritesh
Orthopaedics, Apollo Speciality Hospitals, Chennai, IND.
Orthopaedics, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, IND.
Cureus. 2024 May 13;16(5):e60205. doi: 10.7759/cureus.60205. eCollection 2024 May.
Background Intracapsular femoral neck fractures account for a majority of hip fractures. This study aimed to investigate the efficacy of valgus osteotomy as a primary treatment for intracapsular femoral neck fractures in adult patients aged 15-60 years, assessing its impact on functional outcomes and fracture union. Methodology A retrospective clinical analysis was conducted at the Department of Orthopedics and Traumatology, Osmania Government General Hospital, Hyderabad, India, focusing on patients treated with primary intertrochanteric valgus osteotomy for intracapsular femoral neck fractures. The study reviewed medical charts and radiographs of six patients aged between 15 and 60 years, diagnosed with recent isolated intracapsular femoral neck fractures, presenting between May 2019 and October 2021. The intervention involved Pauwels' intertrochanteric valgus osteotomy with various fixation methods. Main outcome measures included radiographic union, functional ability assessed by the Harris Hip Score, and evaluation for complications. Results All six patients achieved radiographic union at fracture and osteotomy sites, totaling a 100% success rate. The average follow-up duration was 14.8 months (12-20 months), with an average time of 5.1 months (2.5-6 months) from surgery to radiographic union. One patient experienced union with retroversion, while another developed avascular necrosis (AVN) by the study's conclusion. No instances of hardware failure or non-union were observed. The average Harris Hip Score obtained during the most recent clinical follow-up was 84, ranging from 69 to 94. All six patients regained independent walking ability without any support by the end of the follow-up period. Conclusion The combination of primary Pauwels' intertrochanteric valgus osteotomy with fixed-angle plating proves to be a highly effective method for addressing recent intracapsular femoral neck fractures, resulting in a 100% success rate in achieving union among the patient cohort.
囊内股骨颈骨折占髋部骨折的大多数。本研究旨在探讨外翻截骨术作为15至60岁成年患者囊内股骨颈骨折主要治疗方法的疗效，评估其对功能结局和骨折愈合的影响。
在印度海得拉巴奥斯曼尼亚政府综合医院骨科和创伤科进行了一项回顾性临床分析，重点关注接受原发性转子间外翻截骨术治疗囊内股骨颈骨折的患者。该研究回顾了2019年5月至2021年10月期间6例年龄在15至60岁之间、诊断为近期孤立性囊内股骨颈骨折患者的病历和X线片。干预措施包括采用各种固定方法的 Pauwels 转子间外翻截骨术。主要结局指标包括影像学愈合、通过 Harris 髋关节评分评估的功能能力以及并发症评估。
所有6例患者在骨折和截骨部位均实现了影像学愈合，成功率达100%。平均随访时间为14.8个月（12至20个月），从手术到影像学愈合的平均时间为5.1个月（2.5至6个月）。1例患者出现愈合伴旋转不良，而另1例在研究结束时发生了缺血性坏死（AVN）。未观察到内固定失败或骨不连的情况。最近一次临床随访时获得的平均 Harris 髋关节评分为84分，范围为69至94分。所有6例患者在随访期结束时均恢复了独立行走能力，无需任何辅助。
原发性 Pauwels 转子间外翻截骨术与角钢板固定相结合被证明是治疗近期囊内股骨颈骨折的一种非常有效的方法，在患者队列中实现愈合的成功率为100%。
