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Treatment of Displaced Subcapital and Transcervical Fractures of the Femoral Neck by Muscle-Pedicle-Bone Graft and Internal Fixation: A PRELIMINARY REPORT ON ONE HUNDRED AND FIFTY CASES.

Journal of Bone & Joint Surgery - American Volume: March 1973
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Beginning in 1967, all qualified patients (under seventy years of age, ambulatory with a displaced femoral fracture in the neck or subcapital) were treated either by use a fibular graft (twenty-one not considered in detail in this report) or by an iliac graft with quadriceps muscle pedicle in addition to Hagie pins. Four of the 150 patients were lost to follow-up. There were seven deaths and three infections which required removal of the femoral head. Of the remaining 136 patients, there were fifteen non-unions (11 per cent). When, in addition, a posterior defect was found and was filled with bone graft, union occurred in 97 per cent (sixty-four of sixty-six). Of the fifteen non-unions, eight had unsatisfactory reductions or were in uncooperative patients. Late segmental collapse occurred in five patients (of sixty-three followed eighteen or more months) and varus position in sixteen. At follow-up, five patients were practically confined to a wheel chair, fifteen used a walker and seventeen a cane, while the rest were freely ambulatory.

Copyright 1973 by The Journal of Bone and Joint Surgery, Incorporated

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