Treatment of Garden Ⅲ and Ⅳ fractures of the femoral neck in young adults with vascularized bone flap graft
10.3760/cma.j.issn.1001-2036.2013.06.006
- VernacularTitle:带血运骨瓣移植治疗青壮年股骨颈GardenⅢ和Ⅳ型骨折
- Author:
Zhigang LI
;
Hui XIE
;
Dewei ZHAO
;
Benjie WANG
- Publication Type:Journal Article
- Keywords:
Displaced femoral neck fracture;
Lateral femoral circumflex artery;
Iliac bone flap;
Osteonecrosis of the femoral head
- From:
Chinese Journal of Microsurgery
2013;36(6):541-544
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare open reduction and cannulated screws combined with ascending branch of lateral femoral circumflex artery iliac bone flap with closed reduction and cannulated screw fixation for the treatment of displaced femoral neck fracture in young adults.Methods From January 1992 to January 2007,totally 204 cases of displaced femoral neck fracture were treated.Group A:one hundred and three cases were treated with open reduction and 2 cannulated screw fixation,covered by the vascular pedicled iliac bone flap with ascending branch of lateral femoral circumflex artery.Garden classification:type Ⅲ.68 cases,type Ⅳ:35 cases.Group B:one hundred and one cases,treated with closed reduction and three cannulated screw fixation.Garden classification:type Ⅲ in 62 cases and type Ⅳ in 39 cases.Results Two groups were followed up for 5-15 years.The healing time of group A was (73 ±21.2) days,including 4 cases of nonunion fracture (3.9％) and 5 cases of femoral head avascular necrosis occurred (4.9％) ; The healing time of group B was (89 ± 12.5) days,including 12 cases of nonunion fracture (11.9％) and 18 cases of femoral head avascular necrosis occurred (17.8％).The healing time,the rate of nonunion of fracture and the rate of femoral head necrosis were significantly different of these 2 groups.Conclusion The treatment of open reduction and 2 cannulated screw fixation,covered by the vascular pedicled iliac bone flap with ascending branch in young adults can effectively prevent nonunion of fractures and osteonecrosis of the femoral head.
