title: [Treatment of avascular necrosis of femoral head after femoral neck fracture with pedicled iliac bone graft].
abstract: OBJECTIVE
  To explore the effectiveness of pedicled iliac bone graft transposition for treatment of avascular necrosis of femoral head (ANFH) after femoral neck fracture.
  
  
  METHODS
  Between June 2002 and December 2006, 22 cases (22 hips, 16 left hips and 6 right hips) of ANFH after femoral neck fracture were treated with iliac bone graft pedicled with ascending branch of the lateral femoral circumflex vessels. There were 18 males and 4 females with an age range from 28 to 48 years (mean, 37.5 years). The time from injury to internal fixation was 2-31 days, and all fractures healed within 12 months after internal fixation. The ANFH was diagnosed at 15-40 months (mean, 22 months) after internal fixation. The ANFH duration was 3-11 months (mean, 8 months). According to Association Research Circulation Osseous (ARCO) staging system, 2 hips were classified as stage IIa, 3 hips as stage IIb, 3 hips as stage IIc, 3 hips as stage IIIa, 7 hips as stage IIIb, and 4 hips as stage IIIc. The preoperative Harris hip score (HHS) was 64.10 +/- 5.95.
  
  
  RESULTS
  All incisions healed by first intention and the patients had no complication of lung embolism, sciatic nerve injury, lower limb deep venous thrombosis, and numbness and pain of donor site. All patients were followed up 2.5 to 6.3 years (mean, 4.8 years). The fracture healing time was 8-12 months, and no femoral neck fracture recurred. The HHS was 90.20 +/- 5.35 at last follow-up, showing significant difference when compared with the preoperative value (t = -18.447, P = 0.000). The hip function were excellent in 11 hips, good in 10 hips, fair in 1 hip, and the excellent and good rate was 95.5%. Four hips were radiographically progressed in ARCO staging, 18 hips remained stable with a stable rate of 81.8%.
  
  
  CONCLUSIONS
  Pedicled iliac bone graft transposition is an ideal option for treatment of ANFH after internal fixation of femoral neck fracture for the advantages of femoral head revascularization, sufficient cancellous bone supply, and relatively simple procedure.
authors.affiliation: School of Electronics and Information Engineering, Dalian University of Technology, Liaoning, PR China.
authors.forename: Benjie
authors.initials: B
authors.lastname: Wang
authors.forename: Dewei
authors.initials: D
authors.lastname: Zhao
authors.forename: Lin
authors.initials: L
authors.lastname: Guo
authors.forename: Lei
authors.initials: L
authors.lastname: Yang
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Li
authors.forename: Daping
authors.initials: D
authors.lastname: Cui
authors.forename: Fengde
authors.initials: F
authors.lastname: Tian
authors.forename: Baoyi
authors.initials: B
authors.lastname: Liu
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery; D005271:Femur Head Necrosis / Q000209:etiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000098:blood supply