Valgus inter-trochanteric osteotomy is a well -accepted technique for neglected neck of femur fractures in physiologically young patients. There are many studies which compares the outcomes of fixation using angled blade plate vs DHS. However, there are very few studies which compares the functional & radiological outcomes of fixation using double angle DHS and single angle or conventional DHS. The objective of the study is to compare the short term & long term outcomes of these two fixation methods. This is a prospective study conducted on 36 patients( 24 men and 12 women) who were treated by wedge-removing valgus intertrochanteric osteotomy. Average time of presentation was 3.5 months. Average age was 39 (23–49) years. Average Shear angle was 54 degrees.120deg double angle DHS was used in 18 patients & 135deg single angle DHS was used in 18 patients. Average time to union was 2.9 months. There was non-union in 1 case which was managed by total hip replacement. No osteotomy site non-union was seen. There was statistically significant (P=0.03)difference in development of abductor lurch between both groups(1 patient in normal DHS group vs 3 patients in double angle DHS group).There was no significant difference in pain score & union time. Fixation of valgus osteotomy by double angle DHS causes  medialisation  of the femoral shaft which leads to Shortened lever arm for hip abductors causing more abductor lurch in this group of patients. Theoretically, medial shift of mechanical axis causes straining of the medial ligament of the knee, valgus deformity, and ultimately lateral compartment osteoarthritis in future. Also, abnormal orientation of proximal femur makes total joint arthroplasty technically more difficult.

Nihar Ranjan Mishra currently serves as an assistant professor in the department of orthopedics at IMS & SUM Hospital in Bhubaneswar. He obtained his MS in orthopedics in 2019 and further specialized as a fellow in arthroplasty at Ganga Hospital, Coimbatore. Throughout his career, he has authored numerous research articles and case reports published in various esteemed orthopedic journals.