Free Fibular Graft Augmentation in Delayed Fixation of Fracture Neck of Femur in Young Adults.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 4
Abstract
Introduction: This clinical study was conducted to assess the long term follow up results of using free fibular graft to augment fracture fixation with cannulated cancellous screw or dynamic hip screw as a treatment option for femoral neck fractures in young adults who presented after 24 hours of injury but within 3 weeks. Methods: A prospective study was conducted on the patients of femoral neck fractures managed with multiple cancellous screws or dynamic hip screw with fibular graft. Patients aged between 15 and 50 years, having Gardens type III or IV fracture with duration of injury less than three weeks were included in the study. They were assessed for radiological outcome and functional outcome using modified Harris Hip Score. Results: Twenty two cases were operated between day 2 to day 21 after sustaining injury. The mean time of union was 3.4 months. 19 fractures united uneventfully. 2 fractures went in for non union and one developed AVN of femoral head. According to Harris Hip Score,14 patients scored ‘excellent’, 3 patients scored ‘good’, 3 scored ‘fair’, and ‘poor’ score was recorded in 2 patients. Conclusions: Delay in surgery as a contributing factor for development of complications in fracture neck of femur cannot be ruled out with the present literature available. Using a free fibular graft as an adjunct to the implant construct helps in reducing the rates of non-union and AVN. However, this cannot be a substitute for the proper surgical precision that is required in treatment of fracture neck of femur. Further prospective studies involving large sample size are required.
Authors and Affiliations
Dr. Thejaswi. S. G, Dr. B. G. Sagar, Dr. Sunil Kumar PC
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