Shaft of humerus non-union: operated with fibular strut graft and long PHILOS

Introductions: Avascular necrosis and non-union are common but when the neck of femur fracture in adult is neglected, the chances of complications rises. Among various treatment options, we report the outcome of free fibular strut graft along with two cannulated hip screws in neglected fracture neck of femur. Methods: The outcome analysis of ‘fibular strut graft and two cannulated hip screws’ was conducted in patients with fracture neck of femur who presented at least three weeks after the time of injury, during August 2008 to December 2017, at Lumbini Zonal Hospital and Lumbini Hospital Technical College, Butwal, Nepal. All adult patients aged 18 to 60 years were included. Outcome variables were healing of fracture (union, delayed union, non-union), avascular necrosis and Harris Hip Score (HHS). Results: Out of 20 fractures, 17 (85%) united uneventfully, 2 (10%) had delayed union and 1 (5%) nonunion. We had 3 (15%) avascular necrosis of femoral head. The HHS was excellent in 8 (40%), good in 4 (20%), fair in 6 (30%) and poor in 2 (10%). Conclusions: Fibular Strut graft with two hip screws resulted in fracture union and improved hip functions in patients with neglected fracture of neck of femur.

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Assessment of radiological outcomes in gap non-union of long bones using non-vascularised fibular strut graft augmented with corticocancellous graft

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2018.v4.i3a.10 ◽

2018 ◽

Vol 4 (3.1) ◽

pp. 43-46

Author(s):

Rajendraprasad Butala ◽

Abdul Malik Nagori ◽

Vinit Vimal Karn ◽

Prakash Samant

Keyword(s):

Long Bones ◽

Strut Graft ◽

Non Union ◽

Fibular Strut

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A Systematic Review On The Outcomes Of Fibular Strut Graft For Femoral Neck Fractures In Adults

Biomolecular and Health Science Journal ◽

10.20473/bhsj.v4i1.26912 ◽

2021 ◽

Vol 4 (1) ◽

pp. 66

Author(s):

Bintang Soetjahjo ◽

Udi Heru Nefihancoro ◽

Rieva Ermawan ◽

Gilang Teguh Pratama

Keyword(s):

Systematic Review ◽

Femoral Neck ◽

High Energy ◽

Femoral Neck Fractures ◽

Cochrane Library ◽

Bony Union ◽

Scientific Publications ◽

Strut Graft ◽

Non Union ◽

Fibular Strut

Introduction: Femoral neck fractures are a type of intracapsular hip fracture which also be found in younger patients who suffered from high-energy trauma such as vehicle accidents. Non-union and avascular necrosis are the most frequent complications following femoral neck fractures. In this study, we reviewed the outcomes of fibular grafting techniques for femoral neck fractures in adults.Method: Online libraries PubMed, Cochrane Library and Scopus were searched for relevant papers. We searched for scientific publications published between 2009 and 2020. Inclusion and exclusion criteria were used, and prespecified characteristic were extracted from each study.Result: We found 172 papers relevant to the topic. At last, we included 6 papers in this systematic review with a total of 198 patients. Fibular strut graft for femoral neck fractures have shown excellent outcomes, uniting 177 (89,39%) of 198 fractures reviewed. Overall, 15 patients (7,57%) experiencing non-union and 12 patients (6,06%) having avascular necrosis.Conclusion: The outcomes of the intervention turned out to be excellent, assessed by both functional outcome criteria and radiographic bony union. It is important to established a consensus on surgical intervention for femoral neck fractures, specifically including fibular strut grafting.

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Reconstruction of Juxta-Articular Bone Defect in an Infected Fracture Distal Right Femur Using Autologous Fibular Strut and Iliac Crest Graft

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/709 ◽

2021 ◽

Vol 10 (39) ◽

pp. 3501-3504

Author(s):

Nareshkumar Satyanarayan Dhaniwala ◽

Khizar Khusrau Khan ◽

Salahuddin Ahmed

Keyword(s):

Bone Defect ◽

Iliac Crest ◽

Distal Femur ◽

Fracture Site ◽

Open Fractures ◽

Iliac Crest Graft ◽

Strut Graft ◽

Non Union ◽

Femur Fractures ◽

Fibular Strut

Distal femur fractures are about 7 % of all femur fractures.1 Being complex in nature management of these fractures is difficult; management is still a challenge in this technically advanced era. Fibular strut graft is one of the useful and simple options to manage defects in distal femur fractures. High velocity injuries causing open fractures may lead to infection and non-union of fracture if proper debridement and antibiotics are not used as per established protocol. Antibiotics can be given mixed with polymethyl-methacrylate (PMMA) cement formed in beads at the open fracture site or coated over a nail.2 This causes slow release of antibiotics and helps in control of infection. Local infection, damaged soft tissue, ischemia over fracture site, stabilisation of fracture, the hardware used and patient’s co morbidities all play a role in union and infection control of open fractures. Early detection of infection is important to avoid non-union and related complications. Distal femur juxta-articular fracture may develop infection due to fractures and unstable fixation more commonly. This may result in cavity formation and complications like osteomyelitis often leading to bone destruction and sequestrum formation. Its management becomes a challenging task for an orthopaedic surgeon.3- 9 The reconstructive methods are autogenous cortical bone, cancellous bone, allograft, bone substitutes like synthetic bone blocks and bone granules. Free bone transfer is crucial in reconstructing massive defects in distal femur fracture due to properties of rapid healing and being hypertrophic.7-13 Fibula is the best available option for grafting in massive defects of femur due to its characteristics like mechanical strength, length, minimum morbidity, and resistance to infection.3,11,13 A single fibula strut graft can give up to 26 cm of graft. The case reported here is of a patient of juxta-articular bone defect in an infected previously operated fracture distal femur using autologous fibular strut and iliac crest graft

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