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Category: Volume 09 Issue 02 February 2021
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Title: Evaluation of treatment of fractured Neck Femur with Fibular Grafting and Cancellous Hip Screw

Authors: Dr Dilip Gupta (MS Ortho) , Dr Narendra Kumar Chaudhary (MS Ortho), Dr Rahmat Ali (Ms (Ortho), MCh (Ortho) )

 DOI: https://dx.doi.org/10.18535/jmscr/v9i2.04

Abstract

“We come into the world under the brim of the pelvis and go out through the neck of the femur”- William Felding (1964). This phrase speaks volumes regarding the bleak outlook and grave prognosis of fractures of the femoral neck till the early years of the twentieth century it was in a nutshell "the death blow to an old individual" It was little wonder, therefore, that the Smith Petersen nail was received sixty-five years ago as the panacea for femoral neck fractures as a welcome departure from Whitman's closed method of treatment. The treatment of these fractures is so fraught with failures that it has been have labelled as the unsolved fracture. The complex biomechanics acting at the upper end of the femur, the enrolling of synovium into the fracture site, synovial fluid washing away of the fracture haematoma and scanty blood supply to the femoral head all contribute to the high failure rates and unpredictable results. The rationale of treatment of closed fracture neck femur with fibular graft is based upon -: Decompression of the femoral head, interrupting the cycle of ischemia and interosseous hypertension, Removal of necrotic bone, grafting of the defect with fresh cortico-cancellous bone, Placement of a viable cortical bones strut to support the subchondral surface to prevent collapse and enhance the revascularization process by providing a source of mesenchymal stem cells.

Keywords- Abd, Add, AVN, AP, CORR, FWB, inf, JBJS, NWB, PWB, SLR, Tend.

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Corresponding Author

Dr Rahmat Ali (Ms (Ortho), MCh (Ortho) )

Professor and H.O.D (Ortho Department), Maharishi Vashishtha Autonomous State Medical College,

Basti, UP, India