High-Degree Valgus Osteotomy for Severe Femoral Head Osteonecrosis After Femoral Neck Fracture with Nonunion: A Case Report

JBJS Case Connect. 2023 May 19;13(2). doi: 10.2106/JBJS.CC.23.00051. eCollection 2023 Apr 1.

Abstract

Case: A 15-year-old adolescent boy had severe groin pain because of extensive osteonecrosis of the femoral head with collapse, joint space narrowing, and nonunion after a failed internal fixation for femoral neck fracture. We performed a 60° valgus osteotomy that moved the posteromedial small viable portion of the femoral head to the weight-bearing acetabular area. The femoral neck nonunion and the necrosis healed completely, and the spherical contour of the femoral head was regained after postoperative hip joint remodeling.

Conclusions: Good remodeling and congruency were achieved by performing high-degree valgus osteotomy to obtain sufficient viable area below the acetabular roof.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Femoral Neck Fractures* / complications
  • Femoral Neck Fractures* / surgery
  • Femur Head
  • Hip Joint
  • Humans
  • Male
  • Osteonecrosis*
  • Osteotomy