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Treatment of non-united femoral neck fracture by a novel subtrochanteric angulation lateral translation valgus osteotomy (SALVA osteotomy)

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Abstract

Purpose

The ideal treatment of non-united and neglected fracture neck femur in the young adult still remains unclear and is characterized by many biological and biomechanical challenges.

Methods

Twenty-one patients with non-united or neglected fracture neck femur aged between 19 and 50 years were treated by a novel subtrochanteric valgus osteotomy and were followed up for a mean of 26.7 months. Patients were assessed by radiological parameters, the Harris Hip Score, Oxford Knee Score, and Askin Bryan Criteria to categorize the overall outcome of the patients at 24 months. Other outcome measures included the occurrence of AVN, adductor lever arm, leg length discrepancy, and mechanical implant failure.

Results

All patients treated with the SALVA osteotomy consolidated and displayed a marked improvement of functional and radiological outcome measures. Nevertheless, there were 2 mechanical failures in patients with marked osteopenia and three developed AVN.

Conclusions

In patients with un-united/neglected fracture neck femur, SALVA osteotomy appears to be reliable and reproducible. It also restores the abductor lever arm and improves the leg length discrepancy. Technically less demanding conversion to arthroplasty remains still possible prospectively.

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Authors and Affiliations

  1. Orthopedics and Trauma Department, Cairo University, Cairo, Egypt

    Mohamed Hegazy, Naguib Basha, Hassan Elbarbary, Mohamed Tageldeen Mohamed, Nader M. Diab, Abou Bakr Zein, Ahmed Hazem Abdelazeem, Khaled Fawaz, Abdulla Mohamed Ahmed & Ahmed Samir Barakat

  2. Helal Hospital, Cairo, Egypt

    Ebaa Mohamed Abdellatif Ali

  3. Klinik für Unfallchirurgie, Medizinische Hochschule, Hannover, Germany

    Ahmed Hosny Khalifa

Authors
  1. Mohamed Hegazy
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  2. Naguib Basha
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  3. Hassan Elbarbary
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  4. Ebaa Mohamed Abdellatif Ali
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  11. Abdulla Mohamed Ahmed
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All above-mentioned authors participated in the production of this work.

Corresponding author

Correspondence to Ahmed Samir Barakat.

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This work was conducted at Cairo University Hospitals and Helal Hospital, Cairo, in accordance with the ethical standards of the Helsinki Declaration. All participating patients signed an informed consent regarding the procedure, possible complications, and alternative treatment modalities.

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The authors declare that they have no conflicts of interest.

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Hegazy, M., Basha, N., Elbarbary, H. et al. Treatment of non-united femoral neck fracture by a novel subtrochanteric angulation lateral translation valgus osteotomy (SALVA osteotomy). International Orthopaedics (SICOT) 44, 2421–2430 (2020). https://doi.org/10.1007/s00264-020-04527-8

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