Treatment of nonunion of the femoral neck fracture associated with avascular necrosis in a child

Sartorius muscle-pedicle bone graft for osteonecrosis of the femoral head

PURPOSE

This study summarises the clinical efficacy of sartorius muscle-pedicle bone graft in osteonecrosis of the femoral head.

METHODS

A total of 58 patients, including 53 men (61 hips) and five women (6 hips) with osteonecrosis of the femoral head, underwent sartorius muscle-pedicle bone grafting. Association Research Circulation Osseous (ARCO) staging was performed.

RESULTS

The ARCO staging revealed 23 hips of stage I, 36 hips of stage II and eight hips of stage III. The average surgical duration was 65 minutes (range 45-90 minutes). A total of 55 (64 hips) of the 58 patients undergoing surgery were followed up, with a mean follow-up duration of 34.48 months (range, 24-48 months) and a median of 34 months. The outcome was excellent in 27, good in 24, normal in two, and poor in 11 hips, with a total good rating of 79.68 %. The Harris score of the hip joints in the last follow-up was significantly improved compared with pre-surgical scores (P < 0.01). Imaging results showed that 21 hips were improved, 31 hips were stabilized and 12 hips were aggravated (of which 9 hips underwent total hip replacement). The survival rate of femoral head was 81.25 %.

CONCLUSION

Sartorius muscle-pedicle bone graft significantly promotes repair of osteonecrosis of the femoral head, improves the Harris score of the hip joints, with good clinical efficacy. It effectively improves the survival rate of femoral head, delaying or preventing artificial hip replacement.