Outcomes for Pauwels’ Osteotomy in Nonunions of Displaced Femoral Neck Stress Fractures: A Case Series

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Femoral neck stress fractures (FNSF) are rare injuries and have shown poor results after displacement, including nonunion and osteonecrosis (ON). The goal of this study was to retrospectively evaluate a series of patients who underwent a valgus producing intertrochanteric osteotomy for FNSF nonunion and assess the degree of Pauwels’ correction, ON rate, and return to duty. Current functional outcomes were prospectively obtained via a telephone script. Six patients underwent Pauwels’ osteotomy for FNSF nonunion, and all went onto bony union. Three of the six patients progressed onto ON, with two patients requiring a total hip arthroplasty due to life-limiting symptoms. Pauwels’ osteotomy is a reliable salvage procedure for FNSF nonunions. (Journal of Surgical Orthopaedic Advances 29(4):234–239, 2020)

Key words: femoral neck stress fractures, nonunions, Pauwel’s osteotomy, valgus intertrochanteric osteotomy

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Wei Wei Wu, MD; Ryan Christopher Myers, MD; and Kevin Matthew Kuhn, MD

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