Vol. 10 No. 03 (2026), Original Article
Vol. 10 No. 03 (2026)
Original Article

Valgus Intertrochanteric Osteotomy for Neglected Femoral Neck Fractures: Clinical and Radiological Outcomes
Open Access
Open Access

Faisal Amin Ahmed
Assistant Professor, Department of Orthopedic Surgery, Shahid Jakir Hossain Border Guard Hospital, Pilkhana, Dhaka, Bangladesh
https://orcid.org/0009-0006-6834-4733 (unauthenticated)
Selim Reza
Associate Professor, Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka-1207, Bangladesh
https://orcid.org/0000-0002-0540-5459 (unauthenticated)
Tapas Mandal
Assistant Registrar, Orthopaedic Surgery, Gopalgonj Medical College Hospital, Bangladesh
https://orcid.org/0009-0007-8134-0240 (unauthenticated)
S M Raqibul Hasan
Assistant Professor, Sports Medicine & Arthroscopy, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh
https://orcid.org/0009-0008-2113-6130 (unauthenticated)
Abul Fazal
Assistant Professor, Spine Surgery, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh
https://orcid.org/0009-0001-4374-2691 (unauthenticated)
Mohammad Mohsin Mia
Assistant Professor, Ilizarov & Deformity Correction, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh
https://orcid.org/0009-0001-5748-4697 (unauthenticated)
Published 03-11-2026

DOI: 10.5281/zenodo.23913302


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Keywords

femoral neck fracture
valgus intertrochanteric osteotomy
neglected fracture
neck deformity correction
fracture union.

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1.
Valgus Intertrochanteric Osteotomy for Neglected Femoral Neck Fractures: Clinical and Radiological Outcomes. Planet (Barisal) [Internet]. 2026 Nov. 3 [cited 2026 Nov. 7];10(03):1150-4. Available from: https://bdjournals.org/planet/article/view/1627
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Abstract

Background: Neglected and ununited femoral neck fractures in younger patients remain a surgical challenge. Valgus intertrochanteric osteotomy (VITO) converts shear forces into compressive loading across the fracture site and may preserve the native femoral head. Objectives: To evaluate the clinical and radiological outcomes of VITO for neglected femoral neck fractures treated at NITOR between January 2021 and June 2025. Methods & Materials: This prospective observational study included 20 patients with neglected intracapsular femoral neck fractures (Garden III/IV) treated with VITO. The primary outcome was Harris Hip Score (HHS); secondary outcomes included radiographic union, time to union, Pauwels angle correction, and postoperative complications. Results: Twenty patients (13 male, 7 female; mean age 35.5 years, range 10-50) were followed for a mean of 36 months. HHS improved from 46.6 preoperatively to 88 at final follow-up (p<0.001). Union occurred in 18 patients (90%) at a mean of 14.7 weeks. Mean Pauwels angle decreased from 66° to 33.3° (p<0.001). Complications included superficial infection (15%), implant cut-through (10%), osteonecrosis (10%), nonunion (10%), limb shortening (15%), and secondary total hip arthroplasty (10%). Conclusion: VITO achieved high union and significant functional improvement in this cohort and represents a viable head-preserving option for carefully selected younger patients, although the complication rate warrants careful patient selection.
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