Vascularised fibular graft in the management of femoral head osteonecrosis: twenty years later.
The management of osteonecrosis of the femoral head ranges from symptomatic therapy to total hip replacement. Conservative treatment is effective only in small, early-stage lesions. Free vascularised fibular grafting has provided more consistently successful results than any other joint-preserving method. It supports the collapsing subchondral plate by primary callus formation, reduces intra-osseous pressure, removes and replaces the necrotic segment, and adds viable cortical bone graft plus fresh cancellous graft, which has osseoinductive and osseoconductive potential. Factors predisposing to success are the aetiology, stage and size of the lesion. Furthermore, it is a hip-salvaging procedure in early pre-collapse stages, and a time-buying one when the femoral head has collapsed.
Duke Scholars
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Treatment Outcome
- Orthopedics
- Humans
- Fibula
- Femur Head Necrosis
- Bone Transplantation
- 3202 Clinical sciences
- 1103 Clinical Sciences
- 0903 Biomedical Engineering
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Treatment Outcome
- Orthopedics
- Humans
- Fibula
- Femur Head Necrosis
- Bone Transplantation
- 3202 Clinical sciences
- 1103 Clinical Sciences
- 0903 Biomedical Engineering