Eur J Trauma Emerg Surg. 2025 Sep 22;51(1):294. doi: 10.1007/s00068-025-02967-8.
ABSTRACT
PURPOSE: The aim of the study is to introduce our experiences and surgical tips of free vascularized fibular grafting (FVFG) for the treatment of osteonecrosis of the femoral head (ONFH), and explore the clinical effect of the procedure.
METHODS: Between March 2016 and September 2022, the clinical data of 23 patients (26 hips) with ONFH were respectively analyzed. The involved hips were classified as stages III (23.1%), IIIA (57.7%), and IIIB (19.2%) according to the Association Research Circulation Osseous (ARCO) classification. The mean preoperative Harris Hip Score (HHS) was 60.9 ± 9.0. All patients were implemented the FVFG. The fibular bone flap was harvested 10 cm distal to the tip of the fibular head. Regular postoperative follow-up was performed to assess the union of the fibula flap and development of ONFH, and to examine the hip function. Statistically differences were analyzed between the preoperative and postoperative HSS (P < 0.05).
RESULTS: All patients were followed up for 13 to 93 months, and the HHS was 90. 9 ± 4. 5 at the last follow-up, indicating a statistically significant improvement compared to that preoperatively (P < 0.001). Postoperative X-rays, CT and MRI revealed no displacement of the fibular bone flap, and all the bone flap healed well without evidence of ONFH progression.
CONCLUSIONS: The treatment of ONFH with FVFG can significantly improve the hip joint function of patients. Incorporating these surgical tips and our experiences may contribute to improved procedural accuracy, enhanced effectiveness, potential cost-efficiency, and broader applicability for dissemination.
PMID:40982114 | DOI:10.1007/s00068-025-02967-8
