Ununited fracture neck of femur treated with closed reduction and internal fixation with cancellous screw and fibular strut graft

Singh, Daria; Sharma, CS; Bansal, Mahesh Chand; Meena, DS; Asat, RP; Joshi, Narendra

doi:10.4103/0019-5413.34447

Cited by 3 publications

(11 citation statements)

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“…Nine articles reported more than 3 weeks of delay as neglected, 17 23 24 26 27 28 29 30 32 whereas remaining articles mentioned more than 6 weeks as the definition of neglected fracture. 19 25 31 However, the definition of nonunion is quite clear. 20 21 22 No evidence of progressive healing on anteroposterior and lateral radiographs and disabling hip pain within 6 months of primary fixation was considered as nonunion.…”

Section: R Esultsmentioning

confidence: 99%

“…reported open reduction (OR) 17 19 and another seven reported closed reduction (CR) of the fracture site. 22 23 28 29 30 31 32 Five articles reported CR where possible and OR when CR failed. 20 21 24 25 26 The authors supporting OR assert that by opening the nonunion site, the interposed fibrous tissue between the fracture fragments can be removed.…”

Section: R Esultsmentioning

confidence: 99%

“…An initial CR (traction in 45° flexion and then slight abduction followed by extension and internal rotation to 30–45° to bring the limb parallel to the trunk) should be attempted on a traction table. 23 24 28 29 30 31 32 When CR fails (in grossly displaced fracture with neck resorption), OR through Watson–Jones anterolateral approach must be performed. 21 24 25 26 …”

Section: R Esultsmentioning

confidence: 99%

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Nonvascularized fbular grafting in nonunion of femoral neck fracture

Trıpathy

Sen

Goyal

2016

IJOO

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Nonunion of femoral neck fractures following primary fixation and neglected femoral neck fracture in young adults is a challenging task. Every effort should be directed toward hip joint salvage in these patients. Among different available options of hip salvage, nonvascularized fibular graft (NVFG) osteosynthesis is simple, easy to perform, and a successful technique. In this review, the available literature on NVFG in neglected and nonunion femoral neck fractures has been analyzed. After review of 15 articles on NVFG, the average nonunion rate was estimated to be 7.86% (range 0–31%). Six articles that evaluated the preoperative and postoperative osteonecrosis reported improvement in 50% patients. The clinical and/or functional outcome was good to excellent in 56–96% patients following fibular osteosynthesis. Few complications such as coxa vara deformity, limb shortening, and intraarticular penetration of the graft or hardware have been reported. However, there are minimal donor site morbidities such as mild ankle pain, transient loss of toe flexors and extensors and transient lateral popliteal nerve palsy.

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Section: R Esultsmentioning

confidence: 99%

Section: R Esultsmentioning

confidence: 99%

Section: R Esultsmentioning

confidence: 99%

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Nonvascularized fbular grafting in nonunion of femoral neck fracture

Trıpathy

Sen

Goyal

2016

IJOO

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“…FIXATION TECHNIQUES: Systematic reviews still do not come to any clear conclusions on the choice of implant for internal fixation of intracapsular fractures from the available evidence within randomized trials. [13] Parallel screw fixation seems to be the most commonly used technique [1,2,3] but attention has to be put in their correct placement and even then, they are found wanting in situation of gross osteoporosis and comminution of the cortex of the neck. [5] Crossed nails or screws provide better fixation than parallel nails or screws.…”

Section: Case Historymentioning

confidence: 99%

“…Fixation of femoral neck fractures requiring fibular grafting have traditionally been done with one or two cancellous screws. [1,2,3] This type of fixation appears less desirable in the setting of osteoporosis of the trochanteric cortex, like in pathological situations. [4,5] There is very little in contemporary literature regarding use of other implants along with the fibula.…”

Section: Introductionmentioning

confidence: 99%

Patholo Gical Intracapsular Fracture of Neck Femur in a Young Patient : Report of an Innovative Method of Fixation With Review of Literature

Baruah¹

2014

jebmh

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Prospective Study of Osteosynthesis with Fibular Bone Grafting and hip Screw Fixation for Late Femoral Neck Fracture in Young Adults

Pathak,

Bhatti,

Goyal

et al. 2022

Journal of Bone and Joint Diseases

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Background: Intracapsular fracture neck femur has always presented great challenges to orthopedic surgeons and still it continues to be a burning problem; thus, it is often called as an unsolved fracture. The femoral neck fracture is probably the fracture for which there exists the largest number of methods of osteosynthesis. The above quotation reflects the defeatist attitude that has long been held by medical and lay personal toward femoral neck fractures. Materials and Methods: The study was conducted in F.H. Medical College and Hospital, Agra. The cases of this study were selected from the patients attending the outpatient Department of Orthopaedics and from those arriving at the Emergency Department of F.H. Medical College and Hospital, Agra from November 2017 to December 2020. A total of 64 young adults with femoral neck fracture treated by a fibular bone graft with hip screw fixation were included in the study. All the fractures were more than 3 weeks old. Each patient was subjected to detailed clinical and radiological examination along with routine pathological investigations. Result: Results were assessed in 60 patients, whereas 4 patients were excluded from the study due to loss of follow-up. In the subcapital type, 33.3% of cases were found to have good score, 44.4% of cases had fair score, and rest of the cases were found to have poor score. In the transcervical type, 57.4% of cases scored good, 36.1% cases scored fair, and rest of the cases scored poor. In the basal type, 100% of cases were found to have good score. Therefore, transcervical and basal types of fractures have a good prognosis as compared with the subcapital type. The average follow-up was 16.4 months. Out of 60 patients assessed clinico-radiologically. Conclusion: We conclude that treatment of late femoral neck fracture is a simple and cost-effective procedure in young adults with good results.

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Ununited fracture neck of femur treated with closed reduction and internal fixation with cancellous screw and fibular strut graft

Cited by 3 publications

References 0 publications

Nonvascularized fbular grafting in nonunion of femoral neck fracture

Nonvascularized fbular grafting in nonunion of femoral neck fracture

Patholo Gical Intracapsular Fracture of Neck Femur in a Young Patient : Report of an Innovative Method of Fixation With Review of Literature

Prospective Study of Osteosynthesis with Fibular Bone Grafting and hip Screw Fixation for Late Femoral Neck Fracture in Young Adults

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