Biodegradable magnesium screws and vascularized iliac grafting for displaced femoral neck fracture in young adults

Abstract

ObjectiveAvascular necrosis of femoral head and nonunion is a major complication after the treatment of displaced femoral neck fracture in young adults.The purpose of this study was to introduce a new technique using biodegradable magnesium screws and vascularised iliac grafting for displaced femoral neck fracture in young adults.MethodsTotally 19 patients with displaced femoral neck fracture treated with this technique were retrospectively reviewed. The major steps of this technique included the harvesting of vascularized iliac graft, fixing of the fracture and biodegradable magnesium screws combined with vascularized iliac grafting implantation.ResultsAll patients were followed for an average of 16 months (range: 8–24 months). Clinical and radiological outcomes were evaluated. In 18 cases (94.7 %), the hip union was achieved at an average duration of 4.1 months (range: 3.6-5 months). The nonunion was observed in 1 hip (5.3 %) and the revision to a hip replacement was conducted after twelve months of the operation. According to the Harris hip score (HHS) that was available for 17 hips with satisfactory union, excellent results were achieved in 14 cases (HHS ≥ 90), fair results in 3 cases (HHS: 80–90), and poor result in 1 hip (HHS < 80). No patient developed avascular necrosis of femoral head after operation.ConclusionBiodegradable magnesium screws and vascularized iliac grafting based on the ascending branch of lateral femoral circumflex artery for displaced femoral neck fracture in young adults can provide the satisfactory results with a low rate of complications including avascular necrosis and nonunion.Trial registrationThis prospective and randomized controlled study was registered in the Chinese Clinical Trial Registry (ChiCTR-TRC-13003238). Date of registration: 2013-3-21.

Accelerating Corrosion of Pure Magnesium Co-implanted with Titanium in Vivo

“…In a recent clinical study, Yu et al . 15 used vascularized iliac grafting, together with commercial cannulated compression screws and magnesium screws to treat displaced femoral neck fractures in young adults. However, it is well known that the corrosion behavior of Mg would be changed if it is in contact with other metal, or with the β-phase in Mg alloy 16 .…”

Resorbable implants in pediatric fracture treatment

“…Of the 19 cases, 18 showed hip union after an average duration of 4.1 months, whereas only 1 non-union was observed. The Harris hip score revealed 1 poor, 3 fair, and 14 excellent results, and avascular necrosis of the femoral head was not observed in any patient [40].…”

Translational status of biomedical Mg devices in China

“…Zhao et al [39] also used Mg screws for fixation of vascularized iliac grafting during the treatment of displaced fracture of the femoral neck in young adults (Fig. 3).…”

“…According to the Harris hip score (HHS) that was available for 17 hips with the satisfactory union and no patient developed avascular necrosis of femoral head after operation.

Fig. 3A) Preoperative radiographs of a 35-year-old male patient with Garden III fracture; B) The fracture was fixed with Mg screw (red ring) and two cannulated screws and vascularized iliac grafting; C) 12 months postoperative radiographs showing the fracture healing and Mg screw (red ring); D) 24 months postperative moving out cannulated screws and Mg screw fully absorbed [39].

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