Treatment of osteonecrosis in the hip of pediatric patients by free vascularized fibular graft.

Journal Article (Journal Article)

The purpose of the current study was to review the demographics and etiologies of symptomatic femoral head osteonecrosis in the pediatric and adolescent population and to assess the results of treatment using free vascularized fibular grafting. A group of patients with femoral head osteonecrosis who were treated with free vascularized fibular grafting was reviewed. Patients who were studied were 18 years of age or younger at the time of surgery. Records were examined for demographic data, etiology of osteonecrosis, stage of the disease at time of surgery, and results of treatment including preoperative and postoperative Harris hip scores. Eighty-two pediatric and adolescent patients with osteonecrosis of the femoral head underwent 90 free vascularized fibular grafting procedures. Fifty patients (54 hips) who have been followed up at least 2 or more years (average, 4.3 years) constituted the study group. At the last followup, total hip arthroplasty was performed in seven hips (seven patients) and hip fusion was performed in one hip (one patient). The average Harris hip scores in patients who did not undergo total hip arthroplasty improved from a preoperative average of 55.3 points to 90.2 points at the latest followup. Treatment of patients with osteonecrosis with free vascularized fibular grafting resulted in a lower rate of conversion to total hip arthroplasty or fusion (16%) in pediatric and adolescent patients when compared with conversion to total hip arthroplasty in adults (25%). The quality of life as evidenced by the increased Harris hip scores was improved significantly in this group of pediatric and adolescent patients.

Full Text

Duke Authors

Cited Authors

  • Dean, GS; Kime, RC; Fitch, RD; Gunneson, E; Urbaniak, JR

Published Date

  • May 2001

Published In

Start / End Page

  • 106 - 113

PubMed ID

  • 11347822

International Standard Serial Number (ISSN)

  • 0009-921X

Digital Object Identifier (DOI)

  • 10.1097/00003086-200105000-00014


  • eng

Conference Location

  • United States