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KMID : 0361620180530020174
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Journal of the Korean Orthopaedic Association
2018 Volume.53 No. 2 p.174 ~ p.179
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Free Vascularized Fibular Graft for Femoral Head Collapse Combined with Ununited Pathologic Intertrochanteric Fracture
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Kim Hyoung-Min
Cho Hyung-Lae
Lee Jae-Young
Chae Jong-Woo
Shin Myung-Ji
Kim Ji-Un
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Abstract
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Surgery for pathologic hip fracture poses significant challenges regarding the fixation of fracture and management of the original tumor lesion. An extensive destruction of the femoral neck and intertrochanteric region by benign or malignant lesions complicated by a pathological fracture generally necessitates total hip arthroplasty; however, in adolescents and young adults, preservation of the hip is preferable. We present a 14-year-old female patient, who sustained a pathological intertrochanteric fracture through a pre-existing aneurysmal bone cyst. Several operative interventions with internal fixation and bone graft were unsuccessful, and combined nonunion and progression of osteolysis around the compression hip screw eventually caused femoral head collapse, mimicking osteonecrosis. Hip preservation and resolution of the original tumor were achieved by free vascularized fibular graft.
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KEYWORD
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hip, pathologic fractures, nonunion, aneurysmal bone cyst, free vascularized fibular graft
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