Abstract :
Introduction: Till date there is no fool proof method to address neglected fracture neck of femur in young adults owing to its complications such as Non-union (NU) and Avascular necrosis (AVN). Various head preserving surgeries are there, the closed reduction internal fixation of the femoral head, augmented with Tensor fascia lata Muscle pedicle bone graft (TFL MPBG),provides a simple and effective method with excellent to good results in majority of the young patients.
Aim and Objective: To find out the functional and radiological outcome of Osteosynthesis and TFL MPBG in neglected femoral neck fracture in young adults.
Materials and Methods: In this retrospective study we operated on 15 young patients with neglected fracture neck of femur > 3 weeks old. The head was first fixed with Cannulated Cancellous Screw by close method and then TFL MPBG was fixed with a screw at the sub capital region of the head. The final assessment was done upon only those patients who were followed for at least 2 years post operatively using modified Harris hip score.
Results: The average age of patient was 27.8 years; average delay in surgery was 4.7 weeks. The modified Harris hip score was found to be excellent in 8, good in 4, fair in 2 and poor in 1 patient at the end of 2 years follow up. The average duration of surgery was 2 hours 35 minutes, mean shortening of the lower limb was found out to be 1.73 cm in 60% of the patient. No cases of NU and AVN were found.
Conclusion: Among the various head preserving surgeries in neglected fracture neck of the femur in young adults, the CRIF of head with CCS augmented with TFL MPBG fixed with a screw at the sub capital region of the head is a simple, effective and reproducible treatment modality with excellent to good results in majority of the young patients.
Keyword :
Fracture neck of femur, Non union, Avascular necrosis (AVN), Tensor fascia lata (TFL), Modified harris hip score (MHHS)