Pathological Neck of Femur Fracture with Failed Osteosynthesis in Adolescent: A Report of Two Cases

INTRODUCTION: Non-union of the neck of femur fractures in adolescents is a complex problem, especially if there is an underlying pathology such as fibrous dysplasia or unicameral bone cyst. Treatment is challenging and needs careful selection of a combination of strategies. CASE REPORT: We present two such cases with a history of failed osteosynthesis with a sliding hip screw. Our strategy consisted of implant removal, open freshening and cancellous bone grafting of the fracture site, fibular strut grafting, subtrochanteric valgus osteotomy, and fixation with contoured 4.5 dynamic compression plates. Both fractures united uneventfully leaving the patients with good function. CONCLUSION: A combination of the above strategies is a simple and effective approach to achieve union in non-union of pathological fractures in adolescents despite failed osteosynthesis.