The utility of the angled blade plate in hip fracture nonunion treatment: A report of three cases and review of the literature

OBJECTIVES: We report the radiographic and clinical outcome of patients treated with an angled blade plate (ABP) for hip fracture nonunion. We also provide a review of the literature on joint preserving treatment approaches to hip fracture nonunions. DESIGN: Retrospective, case series. SETTING: Tertiary academic hospital. PATIENTS/PARTICIPANTS: Three. INTERVENTION: We treated three patients with varied hip fracture nonunions using a joint preserving approach with an ABP. MAIN OUTCOME MEASUREMENTS: Radiographic union and clinical outcome. RESULTS: All three patients achieved radiographic union, and were ambulating without pain at final follow-up. CONCLUSIONS: The treatment approach to hip fracture nonunions is either restorative (joint preserving) or reconstructive (joint replacing). The primary restorative approach to nonunions around the hip consists of revision open reduction and internal fixation with or without bone grafting. Though a variety of implants and treatment techniques have demonstrated excellent success in this setting, revision open reduction and internal fixation with an ABP remains an efficacious implant selection in hip nonunion surgery.