01Jan 2017

FIBULAR OSTEOSYNTHESIS WITH CANNULATED HIP SCREW FIXATION OF NEGLECTED FEMORAL NECK FRACTURE IN A YOUNG ADULT: CASE REPORT.

  • Post Graduate Student, P.G.Dept. of Orthopaedics ,VSSIMSAR , Burla , Sambalpur University ,Odisha Asso. Professor , P.G.Dept. of Orthopaedics ,VSSIMSAR , Burla , Sambalpur University ,Odisha
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Abstract


Neglected fracture neck of femur is a challenging condition to treat. Preservation of the head of femur is desirable in young patients.In order to preserve the femoral head in femoral neck non-union in young adults, the preferred option of treatment is open reduction and internal fixation. Where there are no facilities for microvascular surgery, non-vascularized fibular strut grafts can be used with screws. This paper describes the use of fibular strut graft and cancellous screws in the open reduction and internal fixation of a neglected femoral neck fracture associated with avascular necrosis of femoral head in a young adult that was followed up for four years. The use of non-vascularized fibular strut grafts and screws for fixation of non-united fractures of femoral necks, even in the presence of avascular necrosis, could lead to union.It is cost-effective and technically less demanding, and associated with good outcomes.


References


  1. Azam MQ, Iraqi A, Sherwani M, Sabir AB, Abbas M, Asif N. Free fibular strut graft in neglected femoral neck fractures in adult. Indian J Orthop 2009;43:62–6.
  2. Bhandari M, Devereaux PJ, Swiontkowski MF, Tornetta P 3rd,Obremskey W, Koval KJ, et al. Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. A metaanalysis. J Bone Joint Surg Am 2003;85-A:1673-81.
  3. Barnes R, Brown JT, Garden RS, Nicoll EA. Subcapital fractures of the femur. A prospective review. J Bone Joint Surg Br 1976;58:2-24.
  4. Compere, E.L. and Lee, J. The restoration of physiological and anatomical function in old ununitedintracapsular fractures of the neck of the femur.J Bone Joint Surg. 1940; 22: 261-277.
  5. 5. Damany DS, Parker MJ, Chojnowski A. Complications after intracapsular hip fractures in young adults. A meta-analysis of 18 published studies involving 564 fractures. Injury 2005;36:131-41.
  6. Dickson JA. The unsolved fracture; a protest against defeatism. J Bone Joint Surg Am 1953;35-A:805-22.
  7. Elgafy, H., Ebraheim, N.A. and Bach, H.G. Revision internal fixation and nonvascular fibular graft for femoral neck nonunion. J Trauma.2011;70: 169–173
  8. LeCroy CM, Rizzo M, Gunneson EE, Urbaniak JR. Free vascularized fibular bone grafting in the management of femoral neck nonunion in patients younger than fifty years. J Orthop Trauma 2002;16:464–72
  9. Loizou CL, Parker MJ. Avascular necrosis after internal fixation ofintracapsular hip fractures; a study of the outcome for 1023 patients.Injury 2009;40:1143-6.
  10. Meyers MH, Harvey JP Jr, Moore TM. Delayed treatment of subcapital and transcervical fractures of the neck of the femur with internal fixation and a muscle pedicle bone graft.OrthopClin North Am 1974;5:743-56.
  11. Nagi, O.N., Dhillon, M.S. and Goni, V.G. Open reduction, internal fixation and fibular autografting for neglected fracture of the femoral neck. J Bone Joint Surg. 1998; 80B:798-804.
  12. Phemister, D.B. Treatment of the necrotic head of the femur in adults. J Bone Joint Surg. 1949; 31A: 55-66.
  13. Roshan, A. and Ram, S. Early return to function in young adults with neglected femoral neck fractures. ClinOrthopRelat Res. 2006; 447:1
  14. Sandhu, H.S., Sandhu, P.S. and Kapoor, A. Neglected fractured neck of the femur a predictive classification and treatment by osteosynthesis. ClinOrthopRelat Res. 2005;431:14–20.

Cite This Article as:


[Dillip Kumar Chand and B.N.Mohapatra. (2017); FIBULAR OSTEOSYNTHESIS WITH CANNULATED HIP SCREW FIXATION OF NEGLECTED FEMORAL NECK FRACTURE IN A YOUNG ADULT: CASE REPORT. Int. J. of Adv. Res. 5 (1). 536-539] (ISSN 2320-5407). www.journalijar.com


DOI:


Article DOI: 10.21474/IJAR01/2778       DOI URL: http://dx.doi.org/10.21474/IJAR01/2778


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