Free Vascularized Fibular Transfer for Femoral Head Osteonecrosis: Donor and Graft Site Morbidity
| Autor: | Trevor R. Gaskill, J. Mack Aldridge, James R. Urbaniak |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Additional Surgical Procedure Adolescent Young Adult Femoral head Femur Head Necrosis Epidemiology medicine Humans Orthopedics and Sports Medicine Fibula Child business.industry Morbidity risk Chronic pain General Medicine Middle Aged medicine.disease Tissue Donors Surgery medicine.anatomical_structure Orthopedic surgery Femoral head osteonecrosis Female business |
| Zdroj: | The Journal of Bone and Joint Surgery-American Volume. 91:1861-1867 |
| ISSN: | 0021-9355 |
| Popis: | Background: Autogenous vascularized fibular transfer is used effectively for a variety of complex reconstructive procedures. Published series demonstrating the morbidity associated with its harvest have, understandably, been relatively small, and graft site (hip) complications have not been reported. This report describes both the donor and the graft site morbidity associated with use of vascularized fibular transfer to treat osteonecrosis of the femoral head. Methods: Between 1990 and 2006, 1270 free vascularized fibular grafts were used to treat osteonecrosis of the femoral head in 946 consecutive patients. All procedures and follow-up examinations were performed by one of two surgeons. Subjective and objective findings were recorded on standardized examination sheets at routine postoperative intervals. Data were analyzed to determine the morbidity associated with donor and graft sites. Results: There were 215 complications (a 16.9% rate) at the time of follow-up, at an average of 8.3 years, after the 1270 procedures. Of these complications, 146 (11.5%) and sixty-nine (5.4%) were referable to the donor and graft sites, respectively. A major complication requiring an additional surgical procedure or chronic pain management occurred after fifty-four (4.3%) of the 1270 procedures. Conclusions: A measurable but acceptable morbidity risk is associated with vascularized fibular transfer for the treatment of osteonecrosis of the hip. Major complications are not frequent, and many minor complications are transient and improve over time. Risks can be minimized when specific technical principles are followed. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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