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Results of triple muscle (sartorius, tensor fascia latae and part of gluteus medius) pedicle bone grafting in neglected femoral neck fracture in physiologically active patients

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Abstract

Background

Femoral neck fractures are notorious for complications like avascular necrosis and nonunion. In developing countries, various factors such as illiteracy, low socioeconomic status, ignorance are responsible for the delay in surgery. Neglected fracture neck femur always poses a formidable challenge. The purpose of this study was to evaluate the results of triple muscle pedicle bone grafting using sartorius, tensor fasciae latae and part of gluteus medius in neglected femoral neck fracture.

Materials and Methods

This is a retrospective study with medical record of 50 patients, who were operated by open reduction, internal fxation along with muscle pedicle bone grafting by the anterior approach. After open reduction, two to three cancellous screws (6.5 mm) were used for internal fxation in all cases. A bony chunk of the whole anterior superior iliac spine of 1 cm thickness, 1 cm width and 4.5 cm length, taken from the iliac crest comprised of muscle pedicle of sartorius, tensor fascia latae and part of gluteus medius. Then the graft with all three muscles mobilized and put in the trough made over the anterior or anterosuperior aspect of the femoral head. The graft was fxed with one or two 4.5 mm self-tapping cortical screw in anterior to posterior direction.

Results

14 patients were lost to followup. The results were based on 36 patients. We observed that in our series, there was union in 34, out of 36 (94.4%) patients. All patients were within the age group of 15–51 years (average 38 years) with displaced neglected femoral neck fracture of ≥30 days. Mean time taken for full clinicoradiological union was 14 weeks (range-10-24 weeks).

Conclusion

Triple muscle pedicle bone grafting gives satisfactory results for neglected femoral neck fracture in physiologically active patients.

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Authors and Affiliations

  1. Department of Orthopaedics, Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India

    Pankaj Kumar Mishra

  2. PRITI Nursing Home, Allahabad, Uttar Pradesh, India

    Anuj Gupta & Suresh Chandra Gaur

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  1. Pankaj Kumar Mishra
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  2. Anuj Gupta
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  3. Suresh Chandra Gaur
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Correspondence to Pankaj Kumar Mishra.

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Mishra, P.K., Gupta, A. & Gaur, S.C. Results of triple muscle (sartorius, tensor fascia latae and part of gluteus medius) pedicle bone grafting in neglected femoral neck fracture in physiologically active patients. IJOO 48, 470–475 (2014). https://doi.org/10.4103/0019-5413.139856

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  • DOI: https://doi.org/10.4103/0019-5413.139856

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