Multi-stage treatment for malunion and avascular necrosis of the femoral head following reverse oblique pertrochanteric fracture: A case report and literature review

Abstract

Femoral reverse oblique intertrochanteric fractures are successfully treated using intramedullary devices. Poor fracture reduction and the use of the inaproppriate implant can lead to implant failure and subsequent malunion or non-union.We present the case of a 21-year-old polytrauma female who, among other injuries, sustained a reverse oblique intertrochanteric fracture that was primarily operated on with the dynamic hip screw. After implant failure the patient developed malunion with bone defect and avascular necrosis of the femoral head. Successful salvage of the bone stock in the inter- and subtrochanteric region was achieved using the two-stage induced membrane technique. The uncemented total hip arthroplasty was performed to address the osteonecrosis of the femoral head.

Keywords

• Induced membrane Masquelet technique
• Bone defect
• Reverse oblique intertrochanteric fracture
• Osteonecrosis
• Femoral head