title: Free vascularized fibular graft for treatment of pathological femoral neck fracture and osteonecrosis of the femoral head: a case report with a long-term follow-up.
abstract: We present a case of a 34-year-old white female patient who, 13 years ago, sustained a pathological intracapsular femoral neck fracture on a pre-existing aneurysmal bone cyst. Three months later radiographic and magnetic resonance imaging evaluation revealed both femoral neck fracture and stage IV osteonecrosis of the femoral head according to Steinberg classification system. Management was accomplished with combined free vascularized fibular grafting and internal osteosynthesis with a 130 degrees blade plate. Union was achieved in 7 months. Progression of osteonecrosis was arrested. Hip salvage and a satisfactory subjective and clinical outcome were achieved. At the last follow-up, 13 years postoperatively, the patient had satisfactory functional outcome.
authors.affiliation: Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece.
authors.forename: Alexandros E
authors.initials: AE
authors.lastname: Beris
authors.forename: Marios G
authors.initials: MG
authors.lastname: Lykissas
authors.forename: Alexandros
authors.initials: A
authors.lastname: Payatakes
authors.forename: Vasileios A
authors.initials: VA
authors.lastname: Kontogeorgakos
authors.forename: Alexandros
authors.initials: A
authors.lastname: Mavrodontidis
authors.forename: Anastasios V
authors.initials: AV
authors.lastname: Korompilias
mesh_terms: D000293:Adolescent; D017824:Bone Cysts, Aneurysmal / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005271:Femur Head Necrosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D005593:Fracture Fixation, Internal; D006801:Humans