Intertrochanteric osteotomy for failed internal fixation of femoral neck fracture.

Thirteen patients with failed internal fixation of the femoral neck were treated with valgus intertrochanteric osteotomy performed by one surgeon from 1987 to 1995. The patients ranged in age from 18 to 59 years. The interval from injury to osteotomy ranged from 4 to 54 weeks. With an average followup of 25 months (range, 9-42 months), the femoral neck fracture healed in all patients. Twelve patients returned to being fully weightbearing without pain. The average limb shortening was improved by 1 cm. Seven of eight patients who were employed before their injuries returned to the same occupations. Femoral head collapse because of avascular necrosis developed in one patient 18 months after surgery and return to full activities and in a second patient shortly after the osteotomy. These two patients now have an arthroplasty. The remainder of the patients have done well without requiring additional surgery. Harris hip scores and Short Form 36 Health Status Survey outcome scoring were available to verify the results in 10 patients.