Free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head

We report on the use of the free vascularized fibular graft (FVFG) as an effective surgical procedure to address the challenging clinical diagnosis of osteonecrosis of the femoral head. The senior author (JRU) has been performing the procedure for approximately 30 years (2800 cases) and has observed several trends related to both the successes and failures of the procedure. As a result of this experience, there are multiple refinements in the patient selection process, surgical technique, and postoperative rehabilitation. We present an overview of the FVFG surgery, our evolving indications, complications arising from the surgery, results, and a synopsis of the surgical technique; an adherence to which, we feel, is paramount to obtaining successful results. © 2008 Lippincott Williams & Wilkins, Inc.

Duke Scholars

Author James Randolph Urbaniak Orthopaedic Surgery