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Abstract Intra - capsular fracture of the ~e~cral neck often :ail to unite because of the excessive shearing strain at the fracture site. Such un-united :racture are fairl• y common in devoloping counteries when their treatment is often delayed ( Baksi , 1986 ) Most authers have assumed that the vascular insault occurs at the moment of fracture and that the fate of ~~e femoral head is decided then. ( L~cie , 1981 ). Muscle pedicle and bone graft woul~ be ideal as a >rimary procedure for displaced femoral neck fractures ~n young adults, in whome the postericr cortex of the neck is usually comminuted and the head has almost certainly lost its vascularity In this series we have 20 cases ~ith fracture neck femur were treated by muscle pedicle bone graft ( 17 ) of them were treated as primary surgical procedure, in other (3 ) patients the operation was the second procedure due to well established non union In conclusion we found that the procedure was --------- - ------------- -------- --- giving a high incidence of satisfactory results in recent fracture in young ~atients with early surgical intervention ,where as the incidence of avascular necrosis and late segmental collapse was increased when the time • between trauma and surgery increased. Also these results are more satisfied than those of internal fixation alone, especially when the degree of displacement is high. (Garden III and Garden IV l. Vascularised pedicular ’-bone graft being viable provides a source of osteogenic cells for callus formation. The most favorable results from bone grafting come from’ the transfere of autogenous cancellous bone into a well vascularised bone bed with viable soft tissues coverage A vascularised’bone is raised on a pedicle of musc le attachment or a main axial vessels, but the mobility of the vascularised pediculated graft is limited by the length of its pedicle 65 Finally in this series, t~e results of th~s operation is much superior than ~he results of s~b-trochanteric osteotomy because of restoration the ahatomy , of the hip joint and resume the normal actvity of the young patients The age , sex osteoporosis the degree of fracture displacement the time of suergery and the quality of the fracture- reduction are factors that have been found to affect the end result. |