WANG Benjie 1 , ZHAO Dewei 2 , GUO Lin 2 , YANG Lei 2 , LI Zhigang 2 , CUI Daping 2 , TIAN Fengde 2 , LIU Baoyi 2
  • 1School of Electronics and Information Engineering, Dalian University of Technology, Dalian Liaoning, 116001, P.R.China;;
  • 2Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University.;
Femoral neck fracture; Avascular necrosis of femoral head; Pediclediliac bone graft; Transposition
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Objective To explore the effectiveness of pedicled il iac bone graft transposition for treatment of avascular necrosis of femoral head (ANFH) after femoral neck fracture. Methods Between June 2002 and December 2006, 22 cases (22 hips, 16 left hips and 6 right hips) of ANFH after femoral neck fracture were treated with il iac bone graft pedicled with ascending branch of the lateral femoral circumflex vessels. There were 18 males and 4 females with an age range from 28 to 48 years (mean, 37.5 years). The time from injury to internal fixation was 2-31 days, and all fractures healed within 12 months after internal fixation. The ANFH was diagnosed at 15-40 months (mean, 22 months) after internal fixation. The ANFH
duration was 3-11 months (mean, 8 months). According to Association Research Circulation Osseous (ARCO) staging system, 2 hips were classified as stage IIa, 3 hips as stage IIb, 3 hips as stage IIc, 3 hips as stage IIIa, 7 hips as stage IIIb, and 4 hips as stage IIIc. The preoperative Harris hip score (HHS) was 64.10 ± 5.95. Results All incisions healed by first intention and the patients had no compl ication of lung embol ism, sciatic nerve injury, lower l imb deep venous thrombosis, and numbness and pain of donor site. All patients were followed up 2.5 to 6.3 years (mean, 4.8 years). The fracture heal ing time was 8-12 months, and no femoral neck fracture recurred. The HHS was 90.20 ± 5.35 at last follow-up, showing significant difference when compared with the preoperative value (t= —18.447, P=0.000). The hi p function were excellent in 11 hi ps, good in 10 hips, fair in 1 hip, and the excellent and good rate was 95.5%. Four hips were radiographically progressed in ARCO staging, 18 hips remained stable with a stable rate of 81.8%. Conclusion Pedicled il iac bone graft transposition is an ideal option
for treatment of ANFH after internal fixation of femoral neck fracture for the advantages of femoral head revascularization, sufficient cancellous bone supply, and relatively simple procedure.

Citation： WANG Benjie,ZHAO Dewei,GUO Lin,YANG Lei,LI Zhigang,CUI Daping,TIAN Fengde,LIU Baoyi. TREATMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD AFTER FEMORAL NECK FRACTURE WITH PEDICLED ILIAC BONE GRAFT. Chinese Journal of Reparative and Reconstructive Surgery, 2011, 25(5): 526-529. doi: Copy