Primary Valgus Intertrochanteric Osteotomy for a Subacute Femoral Neck Fracture in a 37-Year-Old Woman

Case: A 37-year-old woman with a history of depression and polysubstance use disorder presented 3 weeks after developing left hip pain and inability to ambulate. Initial outside radiographs were reportedly negative, delaying diagnosis until a subsequent outside MRI and confirmatory in-house CT demonstrated a displaced AO/OTA 31B2.2 transcervical femoral neck fracture with varus angulation and inferior comminution. She underwent valgus intertrochanteric osteotomy with a fixed-angle blade-plate construct, achieving union and excellent function at 3 years. Conclusion: Valgus-producing osteotomy with blade-plate fixation is a viable joint-preserving option for subacute displaced femoral neck fractures in young adults when arthroplasty is undesirable.