Muscle pedicle bone graft in ununited fracture neck of femur in children

Abstract

Delayed presentation of fracture neck of femur is not uncommon in our scenario and is difficult to treat because of precarious vascularity and bony defect at fracture site. The purpose of the present study is the analysis of functional outcome of the muscle pedicle bone graft porcedure in ununited fracture neck of femur in children and adolescents.: Sixteen patients with ununited fracture neck of femur (presenting late) in children and adolescents were treated with quadratus femoris based muscle pedicle bone graft along with open reduction and internal fixation. Mean age of the patient was 14.25 year (range 12-16 years). Boys dominated our series (n= 10 i.e.62.50%). Road traffic accident was the leading cause. Average injury –surgery interval was 5.88 week (range 3-9 week). A minimum follow up was two years. There were 2 Transepiphyseal, 11 Transcervical and 3 Cervicotrochanteric fractures. Most of the cases showed union in 16 to 24 weeks. In one case there was implant failure. : The result was analysed using Harris Hip Score. We had 11 (68.75%) excellent, 2 (12.50%) Good, 2(12.50%) Fair and one (06.25%) Poor results in our series.Quadratus femoris based Muscle pedicle bone with internal fixation is a very effective method to address the difficult problem of non-union fracture neck of femur. There was statistically significant association (p value <.005) between accuracy of reduction and functional outcome.