Deep circumflex iliac arterial vascularized iliac bone grafting to delayed femoral neck fractures in young patients
- VernacularTitle:带旋髂深血管蒂髂骨瓣植骨治疗青壮年陈旧性股骨颈骨折
- Author:
Jianguo ZHANG
;
Xiang XIAO
;
Tieliang ZHANG
- Publication Type:Journal Article
- Keywords:
Femoral neck fractures;
Fractures, ununited;
Bone transplantation
- From:
Chinese Journal of Orthopaedics
1999;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the early and middle outcome of deep circumflex iliac arterial vascularized iliac bone grafting to delayed femoral neck fractures in young patients. Methods Thirty-one delayed femoral neck fractures were treated from January 1997 to December 2003. Complete data were available in 26 cases (19 males and 7 females). The patients' age ranged from 15 to 38 years old with the average of 25 years old. 17 cases suffered from traffic accidents and 9 cases from falling injury. There were 11 cases in Garden type Ⅲ and 15 cases in type Ⅳ. 11 cases exhibited nonunion after conservative treatment and another 15 nonunion cases had previous surgery history. The initial operation included closed reduction and steinmann pin fixation or open reduction and threaded pin or steinmann pin fixation. The average duration from injury to the second operation was 8.5 months (range from 6 to 17 months). Most of the patients presented shorten limbs and limited hip function in difference degree. Open reduction, deep circumflex iliac artery vascularized iliac bone grafting and cannulate screw fixation were performend. Partial weight bearing started on 6 to 8 months postoperatively and full weight bearing on 11 months postoperatively. Results The mean duration of follow up was forty-one months (range from 28 to 69 months). Fracture healed successfully in 26 cases. The average time of fracture healing was 12.5 months (range from 11 to 15 months). Two femoral head necroses were noted during the follow-up period. The 5 cases of obvious shortened limbs stop progressing after surgery. Harris hip joint function score was on average 82.8. Conclusion Deep circumflex iliac artery vascularized iliac bone grafting can improve the blood supply to fractured femoral head. As a result, it's an effective way to enhance delayed femoral neck fracture.
