Management of Pauwels Type 3 Femur Neck Fracture by Open Reduction Internal Fixation with DHS System and Intertrochanteric Valgus Osteotomy: A Case Series

Abstract

Femur neck is anatomically weaker and prone for fractures in all age groups of population.trauma is major cause of fracture in young individuals. Neck of femur fracture are classified based on anatomical location of fracture , pauwels classification system using orientation of fracture line and gardens system based on trabecular alignment in femur head and acetabulum. In young patients open reduction and internal fixation is preferred choice but in elderly we perform arthroplasty. When fracture is more vertical there are chances of non-union due to shear forces across fracture site.In this case series all the patients are having neck of femur fracture pauwels type 3 and are managed with lateral closing wedge valgus osteotomy at level of lesser trochanter to convert shear forces into compression forces which promotes healing of fracture And fixation is done using DHS system and CC screws .all patients were mobilised with Walker by nil weight bearing initially and followed up at 2 weekly interval later gradually weight bearing started as tolerated and all shows union of fracture and osteotomy site at 12 weeks post op. Keywords: Neck of femur fracture, Pauwels type 3, Pauwels angle, DHS system, Valgus osteotomy, Compression forces