DOI: https://doi.org/10.36347/sasjs.2026.v12i07.001

Pages: 586-589

Background: Intertrochanteric fractures generally demonstrate high union rates owing to the rich vascular supply and osteogenic potential of the trochanteric region. Consequently, nonunion is an uncommon complication, particularly in young adults, in whom preservation of the native hip joint remains a major therapeutic challenge. Case Presentation: We report the case of a 32-year-old male patient presenting with aseptic nonunion of an intertrochanteric femoral fracture initially treated with a standard gamma nail. The patient was lost to follow-up after the index procedure and subsequently presented with severe hip pain, inability to bear weight, limb shortening, and varus deformity following a low-energy fall. Radiographs and computed tomography revealed fracture nonunion associated with implant failure and a residual cervico-diaphyseal angle of approximately 105°. Clinical examination, laboratory investigations, and imaging findings excluded infection. Intervention: Revision surgery was performed through a lateral approach. The procedure included removal of the failed implant, debridement of the nonunion site, excision of fibrous tissue, correction of the varus deformity, and fixation using a long gamma nail. Biological enhancement was achieved with a corticocancellous autograft harvested from the ipsilateral iliac crest. Results: Postoperative radiographs demonstrated restoration of the cervico-diaphyseal angle to approximately 130°, satisfactory implant positioning, and adequate filling of the nonunion site with bone graft. Mechanical stability and anatomical alignment were successfully restored. Conclusion: Aseptic nonunion of intertrochanteric fractures is a rare but challenging condition in young patients. Residual varus malalignment is a major contributor to fixation failure and impaired healing. Successful management requires restoration of both mechanical stability and biological healing potential through deformity correction, stable fixation, and bone gra