Treatment of ununited femoral neck fractures by internal fixation and muscle-pedicle and free cancellous bone grafts

ABSTRACT

Fifty-eight patients under the age of 50 years suffering from nonunion of intracapsular fractures of the femoral neck with or without previous surgical intervention were treated by internal fixation combined with quadratus femoris muscle-pedicle and free cancellous bone grafts. Forty-four cases presented with varying degrees of femoral neck absorption and five with avascular necrosis of the femoral head. Satisfactory bony union occurred in 49 patients [84.5%] and failures in 9 [15.5%]. Failure were noticed mostly after gross absorption of femoral neck and avascular necrosis and cavitation of femoral head due to previous internal fixation. It was seen also after inadequate internal and external immobilization and premature weight bearing against advice. This method of treatment is suitable for patients under age of 50 years suffering from ununited fractures of the femoral neck with or without previous operative fixation provided that there is no gross absorption of femoral neck and no cavitation of femoral head