@article {104531, title = {Triple attack technique for non-union of femoral neck fractures.}, journal = {International orthopaedics}, year = {2015}, month = {2015 Jun 24}, abstract = {

PURPOSE: The purpose of this study was to describe the technique and clinical results following the utilization of biomechanical and biological means for adequate fracture healing in management of non-union of the neck of femur while preventing distortion of normal hip biomechanics.

METHODS: Twenty-two patients with non-united fractures of femoral neck in adults were treated with what was termed the {\textquoteright}triple attack{\textquoteright} procedure. This constituted iliac autogenous bone grafting, valgus subtrochanteric osteotomy together with static fixation across the non-union fracture site of the neck to avoid delayed femoral neck shortening.

RESULTS: All patients were classified as Pauwel{\textquoteright}s type III fractures. The mean time interval between the last operation and the current procedure was 4.6~months. Average operative time was 58.6~minutes. Patients were followed up for an average of 43.6~months. Complete union was achieved in all cases at an average of 4.3~months. Significant improvement of all radiological parameters was noticed together with the Harris hip score from an average of 21.2 pre-operatively to 89.6 at the last follow-up.

CONCLUSION: The present study provides encouraging clinical and functional results to suggest that this newly described procedure ({\textquoteright}triple attack{\textquoteright}) might be a valuable option in the management of non-united femoral neck fractures.

}, issn = {1432-5195}, doi = {10.1007/s00264-015-2808-5}, author = {Hazem Abdelazeem and Ahmed Abdelazeem and Al-Dars, Ahmed and Mohamed Hegazy and Abdellatif, Nasef} }