Osteosynthesis and Reconstruction in Neglected Neck of Femur Fracture: A single-center Study and literature review.

Purpose : Our study evaluates the effectiveness of our innovative treatment for neglected femoral neck fractures. Methods : This retrospective study included 23 patients from January 2016 to March 2023, treated with our new innovative technique. Data has been extracted from the respective department, and informed consent has been obtained prior to any intervention. Radiographs, including AP and lateral radiographs and range of motion at the hip joint, were evaluated in follow-ups at different intervals. Post-operative complications and total hip arthroplasty conversions were also noted. The SPSS software version 26 was used to analyze data for this study. Results : With a mean follow-up of 4.5 ± 1 years, the participants’ ages ranged from 14 to 60 years old, with a mean age of 29.74 ± 11.47 years. The database record indicates that 20 subjects had the radiological and clinical union observed. The non-union was reported in 3 (14.2%) patients; however, only one was symptomatic. Almost 41.7% of the patients reported feeling pain occasionally after exertion. At the operated hip, all patients had excellent range of motion (ROM), primarily in the areas of hip flexion, abduction, adduction, and external rotation. Following reconstruction, the average hip Haris score was 83.46 ± 10.40 at one year. As a post-operative complication, 4 individuals (16.7%) had an infection. Conclusion : Our unique technique has dramatically improved neglected femur neck fractures, even in young patients. It involves ORIF using three cancellous screws, non-vascularized fibular and iliac crest cancellous grafts for reconstruction, and vascularized Tensor fascia lata pedicle graft osteosynthesis.