Role of Pauwels Valgus Osteotomy in Management of Femoral Neck Fractures: A Prospective Study

Background: Femoral neck fractures are significant injuries that can lead to serious complications, particularly non-union and Avascular Necrosis of the femoral head. Altering the angle of the femoral neck, surgeons can improve the chances of healing by changing the mechanical forces acting on the fracture. For this reason, a valgus osteotomy is sometimes performed in cases with a high risk of non-union. This approach has the potential to offer the best long-term outcomes, as it avoids the complications associated with artificial joints and allows the patient to retain their natural hip joint, significantly enhancing mobility and quality of life. Methodology: This prospective study was conducted on 20 patients with neck of femur fractures, at N.S.C.B. Medical College, Jabalpur, between April 2023 and March 2025. Patients were followed up at 1, 3, 6 and 12 months postoperatively for clinical and radiological assessment using the Harris Hip Score (HHS). Results: Of the 20 patients enrolled, 18 patients had a complete follow up of 12 months postoperatively. Majority of patients were in age group of 41-45 years. Mean time for radiological union was 14.75±2.34 weeks. Mean duration of surgery was 97±12.6 min and mean amount of blood loss was 140±34.18 ml. Average HHS after 1,3, 6 and 12 months was 42.8±2.28, 61.7±4.40, 84±4.96, 86.45±5.12 respectively. Conclusion: From our study, we conclude that Pauwels osteotomy combined with internal fixation using a Dynamic Hip Screw (DHS) is a reliable salvage and primary procedure for Pauwels type II and III femoral neck fractures in younger patients, achieving high union rates and satisfactory functional outcomes. Key words: Dynamic Hip Screw (DHS), Harris Hip Score (HHS), Pauwels osteotomy, Femoral neck fractures.