The use of iliac flap pedicled with superficial circumflex iliac artery and sartorius in treatment of femoral neck fracture of young adults

Abstract

Objective To investigate the effect of iliac flap pedicled with superficial circumflex iliac artery and sartorius in the treatment of femoral neck fracture of the young adults. Methods From April, 2012 to March, 2017, 50 cadaveric lower limbs were injected with red latex, and the origin, diameter, course and distribution of the superficial circumflex iliac artery and arteries of the sartorius were observed. The iliac flap pedicled with superficial circumflex iliac artery and sartorius was used to treat the femoral neck fracture in young adults in 11 cases. There were 9 males and 2 females with an average age of 34.5(ranged from 16 to 54) years. The fractures were classified according to Garden: 4 cases of type III and 7 cases of type IV. Regular outpatient follow-up was made. Results The superficial circumflex iliac artery originated from the femoral artery and the initial diameter was (1.2±0.3) mm. The length of the superficial circumflex iliac artery to the anterior superior iliac spine was (8.8±1.3) cm. The superficial circumflex iliac artery run to the anterior superior iliac spine and sent 1-3 periosteal branches into the iliac crest. The sartorius originates from the anterior superior iliac spine, and its proximal artery arises from the superficial circumflex iliac artery and the femoral artery. Link-pattern arterial anastomosises were formed in sartorius by branches of adjacent vascular pedicles, which nourished the ilium flap. All incisions healed by first intention. All cases were followed-up from 16 to 42 months, with an average of 32.3 months. All fractures healed for 3-7 months, with an average of 4.6 months. No fracture nonunion, femoral head necrosis and other complications occurred. Harris hip scores was 93.02±5.33. Seven cases were excellent and 4 cases were good. Conclusion The iliac flap pedicled with superficial circumflex iliac artery and sartorius has rich blood supply, easily performed conducive to promoting fracture healing, and reducing the occurrence of femoral head necrosis. It is an effective method for the treatment of femoral neck fracture in young adults. Key words: Superficial circumflex iliac artery; Sartorius; Ilium flap; Femoral neck fracture; Transplantation