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Osteotomia valgizante subtrocantérica do fêmur proximal para o tratamento da n?o consolida??o das fraturas transtrocanterianas

DOI: 10.1590/S0102-36162012000100005

Keywords: hip fractures, pseudarthrosis, femoral fractures .

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Abstract:

objectives: to evaluate valgus subtrochanteric osteotomy for the treatment of trochanteric non-union. methods: a retrospective study of cases series. from 1998 september to 2009 january, seventeen (17) cases with a diagnosis of non-union of trochanteric fracture were re-operated by the hip group of the ortophaedic and traumatology service of the hospital geral de goiania (hgg). the patients presented pain at the fracture site, a femoral varus angle of less than 120°, and non-union of the fracture in the 3rd months after the initial surgery. results: patients with ages ranging from 30 to 73 years, with a maximum follow-up of 09 years and minimum of 09 years. the mean time from first surgery to osteotomy was six months. bone union was observed in 16 patients, with a mean union time of 12 weeks after surgery. the mean hip varus angle was 1050 (1200 to 900). after surgery, the mean hip valgus angle was 1440 (1550 to 1350). we had one unsuccessful case; a 78-year old patient who had osteogtomy, fixed with dhs of 1500, with valgization to 1540. after six months of follow-up without union of the fracture, it was decided to perform total cemented hip artroplasthy, without complications. conclusion: valgus subtrochanteric osteotomies can be indicated for the treatment of trochanteric treatment of pseudoarthroses, with good final results for bone union, avoiding the need for total hip artroplasthy and maintaining biological fixation, as well as reestablishing the mechanical and anatomical axis of the affected limb.

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