PURPOSE There is vast literature supporting valgus osteotomy in fracture neck of femur. However, little or no distinction has ever been made to evaluate the success of the procedure in these two different scenarios-non-unions due to failed osteosynthesis and neglected fractures neck of femur. The aim of our study was to compare the results of valgus osteotomy in neglected neck femur fractures and non-union fractures of neck of femur. METHODS This is a single tertiary centre-based retrospective study. The records of all patients aged less than 45 years who underwent valgus osteotomy for neck of femur fractures from 2012 to 2017 were evaluated. Patients with fracture neck of femur of over one month's duration, where no previous surgical intervention was undertaken were placed in neglected fracture group. Patients with failed primary osteosynthesis surgery, either cannulated cancellous screw or dynamic hip screw, were placed in fixation failure group. There were 23 patients in neglected group and 17 patients in fixation failure group. Demographical details, fracture patterns, and preoperative radiograph, surgery time, blood loss, post-operative complications, union time, and non-unions were studied in both groups. RESULTS Osteotomy site united in mean time of 11 weeks in fixation failure group and 11.3 weeks in neglected group (p = .434). Time to radiological union of fracture was 16 weeks (12-23 weeks) for neglected fracture group compared to 25 weeks (20-32 weeks) for fixation failure group which was statistically significant (p = .02). Seven out of 17 fractures did not unite in fixation failure group compared to one non-union out of 23 patients in neglected group. (p = .004) There were two loss of fixation with implant failure in fixation failure group compared to none in neglected group (p = .174). Neither of the groups had any surgical site infection. CONCLUSION Valgus osteotomy results in excellent union rates for neglected fractures of neck of femur. However, the union rates of valgus osteotomy are lower in neck femur fractures with failed implants compared to neglected fractures and the procedure should be cautiously used in such circumstances.

中文翻译：

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股骨骨折颈外翻截骨术失败及骨合成失败的经验。

目的有大量文献支持股骨骨折颈外翻截骨术。但是，在这两种不同的情况下，评估该手术的成功率几乎没有区别，甚至没有区别，这是由于骨合成失败和股骨颈骨折而导致的不愈合。我们研究的目的是比较在忽略的股骨颈骨折和股骨颈不愈合骨折中外翻截骨术的结果。方法这是一项基于三级中心的回顾性研究。评价了2012年至2017年所有年龄小于45岁的患者的股骨颈外翻截骨术。股骨颈骨折病程超过一个月且未进行任何手术干预的患者被置于骨折组中。原发性骨置换手术失败的患者，无论是空心松质螺钉还是动力髋螺钉，都被分为固定失败组。忽视组23例，固定失败组17例。对两组的人口统计学细节，骨折类型和术前X线照片，手术时间，失血量，术后并发症，愈合时间和不愈合进行了研究。结果固定失败组的平均截骨时间为11周，而忽略组的平均时间为11.3周（p = .434）。被忽略的骨折组的放射学骨折愈合时间为16周（12-23周），而固定失败组为25周（20-32周），具有统计学意义（p = .02）。固定失败组中17例骨折中有7例未合并，而忽略组中23例中有1例不愈合。（p = .004）与固定组相比，在固定失败组中有2个因植入失败而导致的固定丢失，而在忽略组中则没有（p = .174）。两组均无手术部位感染。结论外翻截骨术可有效治疗股骨颈骨折而避免骨折。然而，与被忽视的骨折相比，在植入失败的颈股骨骨折中，外翻截骨的联合率要低一些，在这种情况下应谨慎使用该方法。结论外翻截骨术可有效治疗股骨颈骨折而避免骨折。然而，与被忽视的骨折相比，在植入失败的颈股骨骨折中，外翻截骨的联合率要低一些，在这种情况下应谨慎使用该方法。结论外翻截骨术可有效治疗股骨颈骨折而避免骨折。然而，与被忽视的骨折相比，在植入失败的颈股骨骨折中，外翻截骨的联合率要低一些，在这种情况下应谨慎使用该方法。