[Treating avascular necrosis of femoral head in young adult by grafting sartorius muscle iliac bone flap].

OBJECTIVE

To explore an improved method of treating avascular necrosis of the femoral head in young adults by grafting the sartorius muscle iliac bone flap.

METHODS

From September 1994 to August 2003, 68 patients (57 males, 11 females; age, 16-58 years) underwent of the transplant the sartorius muscle oliac bone flap into the femoral head after decompression of the femoral head medullary core and removal of the dead bone and the fibrous tissue in the femoral head. The transplantation was performed on 31 patients left-unilaterally, on 37 patients right-unilaterally, and on 7 patients bilaterally. The pathological causes were as follows: alcoholism in 52 patients, prolonged use of hormones in 6, trauma in the hip in 6, and undetermined cause in 4. Their illness course ranged from 8 months to 4 years. According the Ficat staging, 10 patients belonged to Stage I (11 sides), 27 patients to Stage II (31 sides), and 31 patients to Stage III (33 sides).

RESULTS

The follow-up of the 68 patients for 2. 5-11 years averaged 5. 2 years revealed that based on the Harris evaluation for the hip function, 23 patients had an excellent result, 33 had a good result, 10 had a fair result, and 2 had a poor result. The excellent and good results accounted for 82.3%. There was no recurrence after operation.

CONCLUSION

This method has the following advantages: the lesion focus can be eradicated; enough decompression can be achieved, and the blood circulation for the femoral head can be rebuilt. The grafting of the sartorius muscle iliac bone flap can bring the osteogenesis components to the femoral head, promoting the reconstruction of the bones. This method is suitable and effective for the patients with avascular necrosis of the femoral head (Ficat Grades I, II and III) in young adults.