Neglected fracture neck of femur is a common presentation in developing countries like India. We report a case of 58years old male patient which was successfully managed at our institute. Treatment options vary from arthroplasty and osteotomy (with or without graft) to osteosynthesis using various implants and grafting techniques (muscle pedicle, vascularized, and non-vascularised fibular graft). We performed a non vascularised fibular graft with cancellous screw fixation. Patient had a satisfactory bony union without any avascular changes. We emphasize that Non vascularised fibular graft is a treatment option for surgical management of fracture neck of femur. KEYWORDS: Fracture neck of femur, Non-vascularised fibular graft, cancellous screw. INTRODUCTION:Hip fracture is the most common serious injury in the elderly population and the most common reason for admission to an orthopaedic ward. Delay in the treatment is associated with avascular necrosis of femoral head. Various methods of treatment options are available, but none of them give uniformly good results. [1] In younger age groups less than 60 years osteosynthesis is indicated. Various types of osteosynthesis options available are valgus osteotomy, free or vascularised fibular graft, [2] quadratus femoris muscle pedicle graft, [3] combined osteotomy with fibular graft [2] and Non vascularised cortical autografts. Non vascularised cortical autografts have been used for reconstruction of skeletal defects of long bones since long. The grafts are usually removed from fibula, iliac crest or tibia. Less donor site morbidity associated with removal of fibular graft has popularized its use. Taylor, Miller and Ham, in 1975, [4] were the first to use free vascularized bone graft in tibial defect. Literature [2,5] supports osteosynthesis using non vascularised fibular strut graft in both fresh and old femoral neck fracture. We report a case of neglected fracture neck of femur in 58-year old male patient operated with non vascularised fibular graft.

BACKGROUND AND OBJECTIVE:The Irish surgeon Abraham Colles described DRFs (distal radial fractures) in the 1814 volume of the Edinburgh Medical Surgical Journal. Although his description was based on clinical examination alone (because radiography had not yet been invented), it is quite accurate, and it is Colles's name that is most often associated with this fracture in the English-speaking world. Colles stated, "One consolation only remains, that the limb will at some remote period again enjoy perfect freedom in all of its motions and be completely exempt from pain." This claim that all DRFs, despite displacement, will fare well has been a source of criticism. Incidence of fractures of distal radius are increasing due to more geriatric population and road traffic accidents and at the same time surgical treatment option for the same are modified continuously. The fundamental goal treatment of distal radial fractures is restoration of normal or near normal alignment and articular congruity. A recent trend in internal fixation has been a move towards locking screw implants which can rigidly stabilize cancellous fragmented bone that is normally not amenable to screw fixation. RESULT: The study comprised of 15 male and 5 female patients aged from 22 to 70 years with mean age of 42.82 years. The average duration from date of injury to date of surgery was 2.35 days. The follow up ranged from 9 to 18 months. Using the demerit scoring system of Gartland and Werley we had 50% excellent 40% good, 10% fair and 0 poor results. INTERPRETATION AND CONCLUSION:Open reduction and internal fixation of distal radius fracture with volar locking compression plate provides stable fixation, can restore articular congruity and results in good to excellent functional outcome with minimal complication.