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Triple attack technique for non-union of femoral neck fractures

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Abstract

Purpose

The purpose of this study was to describe the technique and clinical results following the utilization of biomechanical and biological means for adequate fracture healing in management of non-union of the neck of femur while preventing distortion of normal hip biomechanics.

Methods

Twenty-two patients with non-united fractures of femoral neck in adults were treated with what was termed the 'triple attack' procedure. This constituted iliac autogenous bone grafting, valgus subtrochanteric osteotomy together with static fixation across the non-union fracture site of the neck to avoid delayed femoral neck shortening.

Results

All patients were classified as Pauwel’s type III fractures. The mean time interval between the last operation and the current procedure was 4.6 months. Average operative time was 58.6 minutes. Patients were followed up for an average of 43.6 months. Complete union was achieved in all cases at an average of 4.3 months. Significant improvement of all radiological parameters was noticed together with the Harris hip score from an average of 21.2 pre-operatively to 89.6 at the last follow-up.

Conclusion

The present study provides encouraging clinical and functional results to suggest that this newly described procedure (‘triple attack’) might be a valuable option in the management of non-united femoral neck fractures.

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Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Orthopaedics Department, Cairo University, Cairo, Egypt

    Hazem Abdelazeem, Ahmed Abdelazeem, Ahmed Al-Dars & Mohamed Hegazy

  2. Orthopaedics Department, Beni Suef University, Beni Suef City, Egypt

    Nasef Abdellatif

Authors
  1. Hazem Abdelazeem
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  2. Ahmed Abdelazeem
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  3. Ahmed Al-Dars
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  4. Mohamed Hegazy
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  5. Nasef Abdellatif
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Correspondence to Ahmed Abdelazeem.

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Abdelazeem, H., Abdelazeem, A., Al-Dars, A. et al. Triple attack technique for non-union of femoral neck fractures. International Orthopaedics (SICOT) 40, 807–812 (2016). https://doi.org/10.1007/s00264-015-2808-5

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  • DOI: https://doi.org/10.1007/s00264-015-2808-5

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