Summary
Twenty-eight patients with displaced femoral neck fractures were operated on with multiple pinning combined with cancellous bone grafting from the ipsilateral greater trochanter. The bone graft was introduced through a drilled channel in the femoral neck without exposing the fracture. At follow-up after 2 years, seven patients had died. Two patients had been reoperated with prosthetic replacement of the hip. Nineteen fractures were united and one had developed segmental collapse. In femoral neck fractures, complications from non-union and segmental collapse are still a major problem. Even if the imparied vascular supply to the femoral head is responsible for most of the complications [11, 15], anatomic reduction and a stable fixation are conductive to fracture union [2]. Comminution of the posterior wall of the femoral neck has a negative influence on the security of fixation due to a persisting posterior gap after reduction [16]. In previous reports, bone grafting of the posterior defect in the femoral neck through an open approach has achieved good results [1, 13]. Only a few studies, however, describe a technique of introducing bone chips through a drilled channel in the femoral neck [10, 17]. The use of the ipsilateral greater trochanter as the sole donor site for bone grafting in femoral neck fractures has not been reported previously.
Similar content being viewed by others
References
Baksi DP (1986) Internal fixation of ununited femoral neck fractures combined with muscle-pedicle bone grafting. J Bone Joint Surg [Br] 68:239–245
Brown JT, Abrami G (1964) Transcervical femoral fractures. J Bone Joint Surg [Br] 46:648–663
Camp JF, Colwell CW (1986) Core decompression of the femoral head for osteonecrosis. J Bone Joint Surg [Am] 68:1313–1319
Chapman MW, Stehr IH, Eberle CF, Bloom MH, Bowill EG Jr (1975) Treatment of intracapsular hip fractures by the Deyerle method. J Bone Joint Surg [Am] 57:735–743
Deyerle WM (1965) Multiple-pin peripheral fixation in fractures of the neck of the femur. Immediate weight-bearing. Clin Orthop 39:135–156
Eriksson S, Widhe (1988) Bone mass in women with hip fractures. Acta Orthop Scand 1:19–23
Ficat RP (1986) Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg [Br] 67:3–9
Garden RS (1961) Low angle fixation in fractures of the femoral neck. J Bone Joint Surg 43:647–663
Garden RS (1964) Stability and union in subcapital fractures of the femur. J Bone Joint Surg [Br] 46:630–647
Gracilla RV, Brahms MA, Rhienelander FW (1986) The treatment of femoral neck fractures with bone grafts and multiple pin. Poster at the American Academy of Orthopaedic Surgeons, New Orleans
Homberg S, Thorngren KG (1984) Preoperative 99mTc-MDP scintimetry of femoral neck fractures. Acta Orthop Scand 55:430–435
Meyer MH (1980) The role of posterior bone grafts (muscle pedicle) in femoral neck fractures. Clin Orthop 52: 143–146
Meyer MH, Harvey JP Jr, Moore TM (1973) Treatment of displaced subcapital and transcervical fractures of the femoral neck by muscle-pedicle bone grafts and internal fixation. J Bone Joint Surg [Am] 55:257–273
Nagi ON, Gautam VK, Maraya SK (1986) Treatment of femoral neck fractures with cancellous screw and fibular graft. J Bone Joint Surg [Br] 68:387–391
Rokkanen P, Slätis P (1974) Devitalization of the femoral head after medial fracture of the femoral neck. Acta Orthop Scand 45:564–571
Scheck M (1980) The significance of posterior comminution in femoral neck fractures. Clin Orthop 152:138–146
Tateosov GI, Michurin NV (1983) Surgical treatment of unstable femoral neck fractures. Westn Khir 131:62–64
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lindequist, S. Bone grafting in femoral neck fractures: Results in 28 cases operated on with multiple pinning and cancellous bone grafting. Arch Orthop Trauma Surg 108, 116–118 (1989). https://doi.org/10.1007/BF00932168
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00932168