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[The vascularized pedicled flap of superior gluteal artery to hip bone chip--a new concept in the revascularization of hip necrosis in adults].

The development and introduction of microsurgical technique has made possible completely new concept of revascularisation surgery in femoral head necrosis. The bone graft described in this presentation is a pedicled one from the lateral ilium. In five femoral head necrosis a pedicled corticocancellous pelvic graft, supplied by the deep branch of the superior gluteal artery, was transplanted in the femoral head. In all cases it was possible to lift out the pelvic graft from the same side as the affected hip joint. Contrary to the medial iliac bone graft (deep circumflex iliac artery) the lateral iliac bone graft (deep branch of the superior gluteal artery) is inserted into the femoral head dorsally. Preoperatively and postoperatively performed selective angiographies are necessary and presented. In all cases an unimpeded perfusion could be shown three months postoperatively. Advantages and indications of the pedicled bone graft are discussed.

Adult↗

[The use of the Richard's dynamic hip screw and hip Zespol fixator in the treatment of proximal femoral fracture].

A series of 49 patients (27 females, 22 males) aged 24-82 operated on due to proximal end of the femur fracture between 1990 and 1995 were included in this study. There were 23 femoral neck fractures and 26 trochanteric fractures. DHS was used in 35 patients and Zespol hip fixator in 14 cases. Good results have been achieved in 85.7%. Neither method proved superior to the other. Poor results occurred in subcapital neck fractures. DHS seems to offer advantage in trochanteric fractures and Zespol method in femoral neck fractures.

Adult↗