Biodegradable magnesium screws and vascularized iliac grafting for displaced femoral neck fracture in young adults

OBJECTIVE: Avascular necrosis of femoral head and nonunion is a major complication after the treatment of displaced femoral neck fracture in young adults. The purpose of this study was to introduce a new technique using biodegradable magnesium screws and vascularised iliac grafting for displaced femoral neck fracture in young adults. METHODS: Totally 19 patients with displaced femoral neck fracture treated with this technique were retrospectively reviewed. The major steps of this technique included the harvesting of vascularized iliac graft, fixing of the fracture and biodegradable magnesium screws combined with vascularized iliac grafting implantation. RESULTS: All patients were followed for an average of 16 months (range: 8–24 months). Clinical and radiological outcomes were evaluated. In 18 cases (94.7 %), the hip union was achieved at an average duration of 4.1 months (range: 3.6-5 months). The nonunion was observed in 1 hip (5.3 %) and the revision to a hip replacement was conducted after twelve months of the operation. According to the Harris hip score (HHS) that was available for 17 hips with satisfactory union, excellent results were achieved in 14 cases (HHS ≥ 90), fair results in 3 cases (HHS: 80–90), and poor result in 1 hip (HHS < 80). No patient developed avascular necrosis of femoral head after operation. CONCLUSION: Biodegradable magnesium screws and vascularized iliac grafting based on the ascending branch of lateral femoral circumflex artery for displaced femoral neck fracture in young adults can provide the satisfactory results with a low rate of complications including avascular necrosis and nonunion. TRIAL REGISTRATION: This prospective and randomized controlled study was registered in the Chinese Clinical Trial Registry (ChiCTR-TRC-13003238). Date of registration: 2013-3-21.