Femur neck is anatomically weaker and prone for fractures in all age groups of population.trauma is major cause of fracture in young individuals. Neck of femur fracture are classified based on anatomical location of fracture , pauwels classification system using orientation of fracture line and gardens system based on trabecular alignment in femur head and acetabulum. In young patients open reduction and internal fixation is preferred choice but in elderly we perform arthroplasty. When fracture is more vertical there are chances of non-union due to shear forces across fracture site.In this case series all the patients are having neck of femur fracture pauwels type 3 and are managed with lateral closing wedge valgus osteotomy at level of lesser trochanter to convert shear forces into compression forces which promotes healing of fracture And fixation is done using DHS system and CC screws .all patients were mobilised with Walker by nil weight bearing initially and followed up at 2 weekly interval later gradually weight bearing started as tolerated and all shows union of fracture and osteotomy site at 12 weeks post op. Keywords: Neck of femur fracture, Pauwels type 3, Pauwels angle, DHS system, Valgus osteotomy, Compression forces
<p class="abstract">Subtrochanteric femur fracture accounts for 25% of all hip fracture and may land up in non-union due to the inadequate reduction and fixation tech, local muscle pull over fragments, biomechanical stress in subtrochanteric region and soft tissue interposition etc., non-union are managed with various choices of implants like exchange nailing , angle blade plate , dynamic condylar screw, augmentation of previous hardware with plate and by providing biological environments at fracture site using bone graft. Strict adherence to principles of providing stability to fracture and providing environment for bony growth gives good clinical outcome. A 52 years old male with subtrochanteric femur fracture was operated with long PFN, later presented to us after 18 months with failure of the hardware and atrophic non-union manifesting as pain during walking and limping. Patient was operated with removal of implant and exchange nailing using femur interlock nail and autologous bone grafting from iliac crest graft. 1 year follow up showed complete bony union and abundant of callus formation. Patient is currently doing all the daily activities and have no complaints at present. At 1 year follow up there is complete union at non-union site and good clinical outcome is achieved. Exchange nailing with interlock nail and autologous bone grafting for treatment of atrophic non-union of subtrochanteric femur fractures gives good clinical outcome.</p>
<p class="abstract"><strong>Background:</strong> Intra-articular distal femoral fracture makes up to 6% of all femur fractures. Because they damage the cartilage surface of the bone, intra-articular fractures can be more difficult to treat. The locking compression plates have nowadays proven to be gold standard in treating both simple as well as complex intra-articular distal femur fractures. This study is to evaluate the complications, functional and anatomical outcome of distal femur fractures, treated by open reduction and internal fixation using distal femoral locking compression plate.</p><p class="abstract"><strong>Methods:</strong> This is<strong> </strong>a retrospective study of 30 patients with intra articular distal femur fractures operated with distal femur locking compression plate during the period of 2015 to 2018 in a tertiary care hospital with age range from 17 to 71 years and follow up till 2 years. Fractures were classified according to AO classification and functional outcome assessed by using Neer criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 10 cases had excellent score (33%), 16 cases (52%) had satisfactory score, 3 cases (11%) had unsatisfactory score and only one case had poor score.<strong> </strong>85.1% of patients were in between satisfactory to excellent results. Complications observed were excessive bleeding, difficulty in reduction, superficial infections, knee stiffness, malalignment and limb length discrepancy.</p><p class="abstract"><strong>Conclusions:</strong> The distal femur locking compression plate is a good implant to be used for distal femur intra-articular fractures. Early surgery, anatomical reduction and early mobilisation are the prerequisites for good functional outcome. Comminution and bone defect on the medial side needs pillar reconstruction by fibular bone graft.</p>
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