• Jan Bartonícek, Jirí Skála-Rosenbaum, and Pavel Dousa.
• Orthopaedic Department, 3rd Faculty of Medicine, Charles University, Prague Srobárova 50 100 34, Prague 10, Czech Republic. bartonic@fnkv.cz
• J Orthop Trauma. 2003 Oct 1; 17 (9): 606-12.

ObjectiveTo evaluate the results of valgus intertrochanteric osteotomy for varus nonunion and malunion of trochanteric fractures.SettingUniversity hospital.DesignRetrospective clinical study.PatientsFifteen patients (age range 29-84 years) with varus malunion (11 cases) or varus nonunion (4 cases). Indication for surgery was nonunion or varus malunion with limb shortening greater than 2 cm associated with limp, abductor muscle insufficiency, hip pain, and back pain.InterventionThe patients were treated by a valgus intertrochanteric osteotomy fixed with a 120 degrees double-angled blade plate.ResultsAverage follow-up was 5.5 years (range 2-10 years). Fourteen patients healed without complications: 12 patients within 4 months; 2 delayed unions within 6 months. One patient required revision surgery for a loss of fixation due to a fall 6 weeks after surgery. This osteotomy also healed. Average lengthening achieved by osteotomy was 2 cm (range 1-5 cm). In all patients, the resulting range of flexion in the hip joint was greater than 90 degrees, Harris hip score before surgery was 73 points (range 61-83), and after surgery 92 points (range 76-98). Osteoarthritis or avascular necrosis of the femoral head did not develop in any of the cases.ConclusionValgus intertrochanteric osteotomy is an effective procedure that reliably restores hip function in trochanteric malunion or nonunion.

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