Transcervical superior wedge resection (osteotomy) and fixation with contoured plate for the non- union of femoral neck fractures.

Abstract

Study was conducted to determine the healing rate of non-union femoral neck fractures following a new transcervical superior based wedge resection and fixation with contoured plate. This study is based on a concept, that the presence of a residual part of the femoral neck on the trochanteric side of the non-union and removal of a wedge with a superior base not only converts shearing forces into compression forces but also provides fresh bone with an osteogenic potential. This is a descriptive case series 'one group pre-test post-test design', conducted from 2010 to 2016 with a sample size of 18, convenience sampling technique with a minimum follow up of 12 months. Eighteen patients with a mean age of 32.44±8.8 years were operated with transcervical wedge resection and fixation. However, only 14 completed a minimum follow up of twelve months. Thirteen (93%) patients achieved union while, one had stable fibrous union which later on developed avascular necrosis and underwent a total hip replacement. There was a mean shortening of 2.05±0.4 cm. Seven (50%) had post-operative Lurch and 4 (28.6%) required shoe raise while 1 had low grade infection.