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The treatment of avascular necrosis of the femoral head with vascularized fibular grafting: a report of three cases

Year 2005, Volume: 39 Issue: 5, 449 - 454, 11.09.2006

Mahmut Komurcu Kaan Erler Serkan Ozdemir Dogan Bek Mehmet Altinmakas

Abstract

Three male patients aged 21, 21, and 24 years were treated with vascularized fibula grafting for avascular necrosis of the femoral head. The disease was found idiopathic in two cases, while one patient was on steroid therapy. According to the Pennsylvania University Staging System, preoperative radiologic stages were 2a, 2b, and 2c. At the end of a mean follow-up period of 31 months (range 30 to 32 months), there was no progression in two patients, whereas the patient with stage 2c disease was found as stage 3b. The mean Harris hip score increased from preoperative 54 (range 52 to 58) to postoperative 93.3 (range 86 to 100). Vascularized fibula grafting may be an alternative method for early stages of avascular necrosis of the femoral head especially in young patients, because it prevents subchondral collapse, delays total hip arthroplasty, and offers a high success rate.

Keywords

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Femur başı avasküler nekrozu tedavisinde vaskülarize fibula grefti uygulaması: Üç olgu sunumu

Year 2005, Volume: 39 Issue: 5, 449 - 454, 11.09.2006

Mahmut Komurcu Kaan Erler Serkan Ozdemir Dogan Bek Mehmet Altinmakas

Abstract

Yaşları 21, 21 ve 24 olan üç erkek hastaya femur başı avasküler nekrozu tanısıyla vaskülarize fibula grefti uygulandı. Hastalık iki olguda idyopatik bulunurken, bir olgu steroid kullanmaktaydı. Ameliyat öncesinde Pennsylvania Üniversitesi radyolojik evrelendirme sistemine göre üç hasta sırasıyla evre 2a, 2b ve 2c şeklinde değerlendirildi. Olgular ameliyattan sonra ortalama 31 ay (dağılım 30-32 ay) izlendi. Evre 2a ve 2b olan olgularda ilerleme görülmezken, evre 2c olan hasta 3b olarak değerlendirildi. Harris kalça skoru ameliyat öncesi ortalama 54 (dağılım 52-58) iken son kontrollerde ortalama 93.3 (dağılım 86-100) bulundu. Vaskülarize fibula grefti uygulaması, subkondral çökme gelişmesini engellemesi, kalça protezi uygulamasını geciktirmesi ve yüksek başarı oranı nedeniyle, erken evreli özellikle genç hastalarda tercih edilebilecek bir tedavi yöntemidir.

Keywords

bone transplantation/methods;femur head necrosis/classification/surgery;fibula/transplantation;steroids/adverse effects;transplantation autologous

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Details

Primary Language English
Journal Section Case Report
Authors

Mahmut Komurcu This is me

Kaan Erler This is me

Serkan Ozdemir This is me

Dogan Bek This is me

Mehmet Altinmakas This is me

Publication Date September 11, 2006
Published in Issue Year 2005 Volume: 39 Issue: 5

Cite

APA Komurcu, M., Erler, K., Ozdemir, S., Bek, D., et al. (2006). The treatment of avascular necrosis of the femoral head with vascularized fibular grafting: a report of three cases. Acta Orthopaedica Et Traumatologica Turcica, 39(5), 449-454. https://doi.org/10.3944/aott.v39i5.643
AMA Komurcu M, Erler K, Ozdemir S, Bek D, Altinmakas M. The treatment of avascular necrosis of the femoral head with vascularized fibular grafting: a report of three cases. Acta Orthopaedica et Traumatologica Turcica. September 2006;39(5):449-454. doi:10.3944/aott.v39i5.643
Chicago Komurcu, Mahmut, Kaan Erler, Serkan Ozdemir, Dogan Bek, and Mehmet Altinmakas. “The Treatment of Avascular Necrosis of the Femoral Head With Vascularized Fibular Grafting: A Report of Three Cases”. Acta Orthopaedica Et Traumatologica Turcica 39, no. 5 (September 2006): 449-54. https://doi.org/10.3944/aott.v39i5.643.
EndNote Komurcu M, Erler K, Ozdemir S, Bek D, Altinmakas M (September 1, 2006) The treatment of avascular necrosis of the femoral head with vascularized fibular grafting: a report of three cases. Acta Orthopaedica et Traumatologica Turcica 39 5 449–454.
IEEE M. Komurcu, K. Erler, S. Ozdemir, D. Bek, and M. Altinmakas, “The treatment of avascular necrosis of the femoral head with vascularized fibular grafting: a report of three cases”, Acta Orthopaedica et Traumatologica Turcica, vol. 39, no. 5, pp. 449–454, 2006, doi: 10.3944/aott.v39i5.643.
ISNAD Komurcu, Mahmut et al. “The Treatment of Avascular Necrosis of the Femoral Head With Vascularized Fibular Grafting: A Report of Three Cases”. Acta Orthopaedica et Traumatologica Turcica 39/5 (September 2006), 449-454. https://doi.org/10.3944/aott.v39i5.643.
JAMA Komurcu M, Erler K, Ozdemir S, Bek D, Altinmakas M. The treatment of avascular necrosis of the femoral head with vascularized fibular grafting: a report of three cases. Acta Orthopaedica et Traumatologica Turcica. 2006;39:449–454.
MLA Komurcu, Mahmut et al. “The Treatment of Avascular Necrosis of the Femoral Head With Vascularized Fibular Grafting: A Report of Three Cases”. Acta Orthopaedica Et Traumatologica Turcica, vol. 39, no. 5, 2006, pp. 449-54, doi:10.3944/aott.v39i5.643.
Vancouver Komurcu M, Erler K, Ozdemir S, Bek D, Altinmakas M. The treatment of avascular necrosis of the femoral head with vascularized fibular grafting: a report of three cases. Acta Orthopaedica et Traumatologica Turcica. 2006;39(5):449-54.