title: Free Vascularized Fibular Grafting for treatment of osteonecrosis of the femoral head secondary to hip dislocation.
abstract: Traumatic dislocation of the hip results in osteonecrosis of the femoral head (ONFH) or avascular necrosis (AVN) in approximately 40% of patients. This high-energy event causes an ischemic insult to the femoral head that may lead to ONFH. Here, we investigate use of Free-Vascularized Fibular Grafting (FVFG) in patients with ONFH after traumatic hip dislocation. Thirty-five patients with FVFG for this indication were reviewed (average follow-up 3.3 years, range 1-21). We reviewed patient injury statistics, demographics, preoperative radiographs, pre- and postoperative Harris Hip scores, complications, and rate of conversion to total hip arthroplasty (THA). The majority (81%) of our patients were young males (22 years) with ONFH diagnosed an average of 2 years after injury. The average preoperative Harris Hip score was 64.9 which improved by over 10 points to 76.1 at 1-year follow-up. Seven of 35 patients required conversion to THA at an average of 45 (13-86) months postoperation. After a maximum follow up of 21 years, the remainder of the patients retained their native hips and Harris Hip scores tended to show improved hip function.
authors.affiliation: Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Grant E
authors.initials: GE
authors.lastname: Garrigues
authors.forename: J Mack
authors.initials: JM
authors.lastname: Aldridge
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Friend
authors.forename: James R
authors.initials: JR
authors.lastname: Urbaniak
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D005260:Female; D005271:Femur Head Necrosis / Q000209:etiology / Q000601:surgery*; D005360:Fibula / Q000098:blood supply*; D006617:Hip Dislocation / Q000150:complications* / Q000628:therapy; D025981:Hip Injuries / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000209:etiology / Q000601:surgery; D055815:Young Adult