{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:28:09Z","timestamp":1785576489906,"version":"3.56.0"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Nonunion of femoral neck fractures following internal fixation presents a significant challenge, particularly in young patients. This study evaluated the efficacy of valgus osteotomy in treating femoral neck fracture nonunion after failed internal fixation in young adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted including a total of 23 male patients with a mean age of 32.9 years, who underwent valgus osteotomy for femoral neck fracture nonunion. The procedure involved lateral closing wedge osteotomy at the subtrochanteric level, followed by fixation with a dynamic hip screw (DHS). The postoperative follow-up period exceeded one year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant improvements in biomechanical parameters were observed. The mean neck-shaft angle increased from 118.91\u00b0 to 139.26\u00b0 (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001), whereas the Pauwels angle decreased from 62.07\u00b0 to 46.91\u00b0 (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). The median Harris Hip Score improved from 63 to 96 (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). Limb length demonstrated a trend toward improvement, increasing from a median of 73.30\u201374.50\u2005cm, although this was not statistically significant (<jats:italic>p<\/jats:italic>\u2009=\u20090.077). Union was achieved in 22 of 23 patients, with a median healing time of 8.5 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Valgus osteotomy is an effective treatment for femoral neck fracture nonunion in young adults, offering improved biomechanics, good union rates, and enhanced functional outcomes. This technique is a viable option for preserving the native hip joint in challenging patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1526384","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T06:46:47Z","timestamp":1739774807000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy of valgus osteotomy in treating nonunion of femoral neck fractures post-internal fixation"],"prefix":"10.3389","volume":"12","author":[{"given":"Haohao","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenda","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ao","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruofei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujiang","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"105","DOI":"10.3892\/etm.2020.9235","article-title":"Serum miRNA-142 and BMP-2 are markers of recovery following hip replacement surgery for femoral neck fracture","volume":"20","author":"Gao","year":"2020","journal-title":"Exp Ther Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S222","DOI":"10.1097\/SAP.0000000000002364","article-title":"Open reduction and internal fixation and intraoperative exploration of the superior retinacular arterial system in young adults garden III femoral neck fracture: a 10 case report","volume":"84","author":"Wang","year":"2020","journal-title":"Ann Plast Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1007\/s00402-011-1344-z","article-title":"Autologous bone cylinder transplantation with cannulated screw re-stabilisation: a new treatment option for delayed fracture healing of the femoral neck","volume":"131","author":"Frank","year":"2011","journal-title":"Arch Orthop Trauma Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"31","DOI":"10.2147\/ORR.S153451","article-title":"Hip muscle power recovery after hip replacement using anterior-based muscle-sparing approach in elderly femoral neck fracture: a prospective study in 40 patients","volume":"10","author":"Chulsomlee","year":"2018","journal-title":"Orthop Res Rev"},{"key":"B5","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/1749-799X-8-4","article-title":"Valgus sliding subtrochanteric osteotomy for neglected fractures of the proximal femur; 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