Early Effect Of Iliac Bone Flap Pedicled With Sartorius On Repairing Old Femoral Neck Fracture In Young Adults

Objective: This study mainly observed the early clinical efficacy of using iliac bone flap pedicled with sartorius combined with proximal femoral locking plate in young adults patients with old femoral neck fractures.Methods: Ten patients with old femoral neck fractures in young adults admitted to our department from 2012 to 2019 were selected,8 males and 2females,aged 14-47 years,average 32.3 years old,Garden classification: 1 case of type II,6 cases of type III,3 cases of type IV;The Injury to this operation has lasted three weeks to 12 months,with an average of 5.25 months;8 cases of fracture end with varying degrees of femoral neck resorption,2 cases with avascular necrosis of femoral head stage II(Ficat stage).All of the 10 patients received iliac bone flap pedicled with sartorius grafting combined with proximal femoral locking plate internal fixation,X-ray reexamination was performed 1month,3 months,6 months,1 year and 2 years after surgery,the affected limb was partially loaded when the fracture line was blurred and completely loaded when the fracture line disappeared.Fracture healing was assessed by radiographic X-rays,hip function Harris score was used to assess hip function recovery.Results: Ten patients were followed up for 0.5 to 6 years,an average of 1.8years,two fractures were in the healing stage,7 fractures had healed,and 1 case received hip replacement due to fracture nonunion and avascular necrosis of the femoral head.The final hip function Harris score of 7 patients with healing was averaged 52 points from preoperative(34-76 points),increased to(90-100points)with an average score of 97.7 points.One of the patients developed ischemic necrosis of the femoral head 2 years and 4 months after surgery(10months after the removal of internal fixation),but the hip function was good.The patient with hip arthroplasty,the hip function Harris score increased from 59 points before surgery to 100 points;The results of the last hip function(Harris score)in 10 patients were excellent in 8 cases and fair in 2 cases.Conclusion: Early effect of iliac bone flap pedicled with sartorius on the repair of femoral neck fracture in young adults is good,Which can be used as an effective and feasible method for the treatment of old femoral neck fractures in young adults.The long-term effect of iliac bone flap pedicled with sartorius on the repair of old femoral neck fracture in young adults needs further verification,In addition,the treatment of old femoral neck fractures in young adults is still a serious problem,and a large number of multi-center randomized controlled experimental studies are still needed.