NON UNION NECK FEMUR

[CHERRY KOVOOR]

Dear Friends

Kindly advice what can be done

20 yr old male

Pt had a fall 1 yr ago-went to an ortho surgeon tokk x-ray-told hip fracture and advised surgery

Pt did instead ayurvedic massage and now comes 1 yr later with limping and pain

Examination- 3 CM shortening, Limping

R HIP--Trendelenburg _ Positive

no tenderness, hip movements FLEX-100 EXT 0 ABD-20 ADD-40 Ext rot-40 Int rotation=40

All movements terminally painful

R knee- Lachman’s and anterior Drawyer positive

X-ray Non union fracture neck femur with ?viable head and very short neck

Attaching x-rays

 

Regards

 

DR CHERIYAN KOVOOR

KOCHI   INDIA

[George Thomas]

Dear Cherry,

In this young male I would do an angulation osteotomy as described by Muller and fix with a double angled plate.

I have personally performed only 8 such procedures. Every one of them went on to unite.

Prof. Nagi from Rohtak has published a large series.

In the latest issue of the Journal of Bone and Joint Surgery American, there is a large series from the Christian Medical College Vellore. 

Sincerely 

On Sun, 28 Nov 2021, 15:12 'nikhil goradia' via IndiaOrth, <indi...@googlegroups.com> wrote:

I'd like to fix the fracture with a Richard's screw along with a Fibular strut graft.  Do a subtroch angulation osteotomy, fixed with barrel-plate (double-angled preferably). 

Later, reexamine the knee for instability,  and treat as necessary.

Regards

Nikhil Goradia

Sent from Yahoo Mail on Android

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[George Thomas]

Correction :

Latest article from CMC Vellore is not on non union neck femur.

That one was published several years ago. 

Sincerely, 

[Alexander Chelnokov]

Hi

вс, 28 нояб. 2021 г. в 10:03, CHERRY KOVOOR <kovo...@gmail.com>:

20 yr old male

Pt had a fall 1 yr ago-went to an ortho surgeon tokk x-ray-told hip fracture and advised surgery

It is worth to perform an image in maximal adduction, as preop planing and preparation to some kind of valgus intertrochanteric osteotomy.

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Best regards,
 Alexander N. Chelnokov

Ziv Medical Center, Tsfat, Israel