الفهرس 
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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
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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
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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.