Document Detail

Free vascularised fibular graft for post-traumatic osteonecrosis of the femoral head in teenage patients.
MedLine Citation:
PMID:  21969428     Owner:  NLM     Status:  MEDLINE    
Free vascularised fibular grafting has been reported to be successful for adult patients with osteonecrosis of the femoral head (ONFH). However, its benefit in teenage patients with post-traumatic ONFH has not been determined. We evaluated the effectiveness of free vascularised fibular grafting in the treatment of this condition in children and adolescents. We retrospectively analysed 28 hips in 28 patients in whom an osteonecrotic femoral head had been treated with free vascularised fibular grafting between 2002 and 2008. Their mean age was 16.3 years (13 to 19). The stage of the disease at time of surgery, and results of treatment including pre- and post-operative Harris hip scores, were studied. We defined clinical failure as conversion to total hip replacement. All patients were followed up for a mean of four years (2 to 7). The mean Harris hip score improved from 60.4 (37 to 84) pre-operatively to 94.2 (87 to 100) at final follow-up. At the latest follow-up we found improved or unchanged radiographs in all four initially stage II hips and in 23 of 24 stage III or IV hips. Only one hip (stage V) deteriorated. No patient underwent total hip replacement. Free vascularised fibular grafting is indicated for the treatment of post-traumatic ONFH in teenage patients.
C Q Zhang; Y Sun; S B Chen; D X Jin; J G Sheng; X G Cheng; J Xu; B F Zeng
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  93     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-04     Completed Date:  2011-11-22     Revised Date:  2011-12-09    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  1314-9     Citation Subset:  AIM; IM    
Shanghai Sixth People's Hospital, Department of Orthopaedic Surgery, 600 Yishan Road, Shanghai 200233, China.
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MeSH Terms
Arthroplasty, Replacement, Hip
Bone Transplantation / methods
Epidemiologic Methods
Femoral Neck Fractures / complications
Femur Head Necrosis / etiology,  radiography,  surgery*
Fibula / blood supply,  transplantation*
Fractures, Ununited / complications
Treatment Outcome
Young Adult

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