Persistent femoral neck non-union despite valgus intertrochanteric osteotomy: Relevance for secondary cam-type impingement

Abstract

Valgus intertrochanteric osteotomy is a well-established treatment in delayed union of femoral neck fractures as it converts shear forces into compression forces. Non-union of the femoral neck fracture may persist following valgus intertrochanteric osteotomy, and secondary femoroacetabular impingement (FAI) may be a contributing factor. Case: We report one case of persistent femoral neck non-union after treatment by valgus intertrochanteric osteotomy with concomitant secondary cam-type impingement from fracture callus as a possible cause for ongoing insufficient healing. Healing was achieved following surgical hip dislocation with corrective osteochondroplasty of the femoral head-neck junction. Two-year follow-up shows good clinical and radiological outcomes. Conclusion: In ongoing non-healing of femoral neck fractures following valgus intertrochanteric osteotomy, secondary cam impingement from fracture callus must be excluded.

Keywords

• Femoral neck fracture
• Valgus intertrochanteric osteotomy
• Femoroacetabular impingement
• FAI
• Secondary cam-type femoroacetabular impingement
• Surgical hip dislocation