Date: Wed, 18 Feb 2004 19:36:32 +0500
From: Alexander Chelnokov
Subject: Femoral Neck Nonunion - Blade plate cut out
A male 56 years old was operated in Aug 2003 - valgus osteotomy performed because of delayed admission with neck fracture (2 months) images 1,2. Smoker, no other major medical problem.
Now he re-admitted with the images 3,4.
What would you do in the situation?
THX in advance.
Alexander N. Chelnokov
Ural Scientific Institute of Traumatology and Orthopaedics
str.Bankovsky, 7. Ekaterinburg 620014 Russia
Date: Thu, 19 Feb 2004 01:17:26 EST
I suggest hip arthroplasty at this time with a combined "osteotomy/arthroplasty" technique where the cementless femoral stem stabilizes the subtrochanteric osteotomy (or in this case, repeat osteotomy).
References: J of Arthroplasty "Osteotomy Arthroplasty 2 yr followup" circa 1989 DeCoster Incavo Frymoyer and Iowa Orthop Journal "Osteotomy Arthroplasty 10 yr followup" circa 1998 same authors.