title: Fixation using cannulated screws and fibular strut grafts for fresh femoral neck fractures with posterior comminution.
abstract: OBJECTIVE
  To evaluate the use of fibular grafting for fresh femoral neck fractures with posterior comminution.
  
  
  METHODS
  18 women and 15 men aged 20 to 60 years underwent osteosynthesis and fibular strut grafting supplemented with 7.0-mm cannulated hip screws for Garden grades III (n=21) and IV (n=12) femoral neck fractures associated with posterior comminution. All fractures were reduced by closed methods, and no hip was aspirated. Clinical and radiological outcomes were evaluated.
  
  
  RESULTS
  The mean delay in presentation after injury was 3.2 (range, 1-12) days. The mean delay in operation was 8.8 (range, 5-21) days. The mean follow-up period was 2 (range, 1-4) years. According to the Harris hip score, outcome was good to excellent in 20 patients, fair in 7, and poor in 6. 27 of the 33 patients achieved bone union after a mean of 4.7 (range, 4.2-7) months. In 5 patients, the bone was united with a mean of 10º of varus collapse and a mean of 1 cm of shortening. Six patients had non-union. Other complications included screw migration in the joint space (n=1), graft migration into the joint space (n=3), and screw pullout (n=5). No patient had avascular necrosis of the femoral head.
  
  
  CONCLUSIONS
  Osteosynthesis and fibular grafting for freshly displaced femoral neck fractures with posterior comminution is an inexpensive and technically less demanding procedure for retaining a stable, painless, mobile, and functional hip.
authors.affiliation: Department of Orthopedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zahid
authors.forename: Aamir
authors.initials: A
authors.lastname: Bin Sabir
authors.forename: Naiyer
authors.initials: N
authors.lastname: Asif
authors.forename: Mohammad
authors.initials: M
authors.lastname: Julfiqar
authors.forename: A Q
authors.initials: AQ
authors.lastname: Khan
authors.forename: Sohail
authors.initials: S
authors.lastname: Ahmad
authors.forename: Yasir S
authors.initials: YS
authors.lastname: Siddiqui
mesh_terms: D000328:Adult; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005360:Fibula / Q000637:transplantation*; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult