Maluniting Intertrochanteric Fracture – Whats Your Option : Our Experience Of 7 Cases With High Subtrochanteric Osteotomy

Introduction : Malunion of intertrochanteric fractures is common in developing countries as many people rely on indigenous treatment and splintageforfractures.It is not uncommon to see many patients presenting late after the fracture has started to unite when patients notice that the involved limb is short and externally rotated during change of splints (usually done every 15 days).Malunion of intertrochanteric fractures is also common after internal fixation of fractures due to inadequate reduction or failure of fixation.Material and methods : A total of 12 cases operated from May 2014 to December 2016 by the senior author .Average age of the patient was 64 years and mode of injury was slip and fall in most cases.Patients presented at an average of 3 months after the fracture.High subtrochanteric lateral closing wedge valgus osteotomy and internal fixation with dyanamic hip screwwas done.Results : All the 12 patients were followed for a period of 1 year.Union at osteotomy site was achived in all the patients.There were significant improvement in range of movements due to improvement in neck shaft angle.Limb length discrepancy improved to about 0.5 cms. Conclusion : Subtrochanteric lateral closing wedge valgus osteotomy and internal fixation with dynamic hipfor malunitingintertrochanteric fracture showed good results and it is also and effective alternative for supervised neglect/arthroplasty in providing apainfree mobile joint .