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Treatment of Displaced Subcapital and Transcervical Fractures of the Femoral Neck by Muscle-Pedicle-Bone Graft and Internal Fixation A PRELIMINARY REPORT ON ONE HUNDRED AND FIFTY CASES
MARVIN H. MEYERS; J. PAUL HARVEYJR.; TILLMAN M. MOORE
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From the Los Angeles County-University of Southern California Medical Center, Los Angeles
1973 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1973; 55:257-274 
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Abstract

Beginning in 1967, all qualified patients (under seventy years of age, ambulatory with a displaced femoral fracture in the neck or subcapital) were treated either by use a fibular graft (twenty-one not considered in detail in this report) or by an iliac graft with quadriceps muscle pedicle in addition to Hagie pins. Four of the 150 patients were lost to follow-up. There were seven deaths and three infections which required removal of the femoral head. Of the remaining 136 patients, there were fifteen non-unions (11 per cent). When, in addition, a posterior defect was found and was filled with bone graft, union occurred in 97 per cent (sixty-four of sixty-six). Of the fifteen non-unions, eight had unsatisfactory reductions or were in uncooperative patients. Late segmental collapse occurred in five patients (of sixty-three followed eighteen or more months) and varus position in sixteen. At follow-up, five patients were practically confined to a wheel chair, fifteen used a walker and seventeen a cane, while the rest were freely ambulatory.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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