Table 1 Characteristics of the studies included in the systematic review
ID | Region | Study design | Age (years, mean, or range) | Male (%) | Patients | Complications | Cause | Fracture classification | Sample size | Intervention | Follow-up (months) | Outcomes |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Meyers, 1973 [8] | USA | Retrospective study | 36 (24%) of the patients were below the age of 55 | 43.3 | Displaced subcapital and transcervical femoral neck fractures | Alcoholism (delirium tremens and severe liver damage) | Alcoholics | Subcapital and transcervical fractures | 150 | Muscle-pedicle-bone graft and internal fixation | 3–48 | Nonunion rate, collapse rate |
Meyers, 1975 [32] | USA | Case series | 21–39 | 73.9 | Displaced fracture of the femoral neck | NA | Severe trauma | Concomitant ipsilateral fracture of the femur (femoral shaft or intertrochanteric area) | 23 | Open reduction and internal fixation as well as muscle-pedicle graft | 13 patients were followed for over 18 months and 9, for over 24 months | Nonunion rate |
Morwessel, 1985 [31] | USA | Retrospective study | 39 (20–60) | 76.9 | Displaced femoral neck fracture | Other associated injuries | Fall and motor vehicle accident | Subcapital fractures (Garden type III or IV) | 13 | Quadratus femoris muscle pedicle bone grafting with screw fixation | 38 (17–100) | Nonunion rate, collapse rate, reoperation rate |
Baksi, 1986 [30] | India | Case series | 42 (11–67) | 33.9 | Ununited femoral neck fractures | Renal diabetes, hypertension, psychiatric disorders | NA | Intracapsular fracture | 56 | Internal fixation combined with muscle-pedicle bone grafting | 34.6 (18–82) | Nonunion rate |
Biswas, 1997 [29] | India | Case series | 18–47 | 100 | Non-union of fracture neck femur of 6–12 months | NA | Road traffic accident, fall from bicycle and falls on uneven ground | Intracapsular fracture | 12 | Open reduction and internal fixation and tensor fascia lata or gluteus medius muscle pedicle bone grafting | 18 (6–24) | Nonunion rate, effective rate |
Liu, 2003 [28] | China | Case-controlled | 42.5/43.5 | 30/30.4 | Fresh transcervical or subcapital fractures of the femoral neck | NA | NA | Subcapital fractures or transcervical | 30/23 | Muscle bone flap of both sartorius with or without tensor fasciae Iatae | 48 (36–60) | Reoperation rate, effective rate |
Yang, 2006 [27] | China | Case series | 30.6 (21–49) | 60.5 | Femoral neck fractures | NA | Traffic accident, falls from height, and other falls | Garden type III or IV | 86 | Compressed screw and sartorius bone flap | 29 (6–84) | Nonunion rate, avascular necrosis rate, reoperation rate, effective rate (Kan Wusheng) |
Gupta, 2007 [26] | India | Case series | 24 (10–40) | 80 | Ununited fractures of the femoral neck | ununited fractures | NA | Intracapsular fracture | 20 | Internal fixation and muscle pedicle periosteal grafting | 70 (14–144) | nonunion rate |
Chaudhuri, 2008 [25] | India | Case series | 54.6 (24–81) | 63 | Fresh displaced femoral neck fracture | NA | Road traffic accident and falls at their residence | Garden stage III and stage IV | 73 | Quadratus femoris muscle pedicle bone grafting | 67.2 (24–132) | Nonunion rate, Reoperation rate, coxa vara rate, avascular necrosis rate, effective rate |
Gupta, 2008 [24] | India | Case series | 45 (14–62) | 81.3 | Displaced femoral neck fractures | NA | Road traffic accident, falls from height, and slip while walking. | Garden stage III, IV | 32 | Open reduction and internal fixation with muscle pedicle grafting | 40.8 (24–102) | Avascular necrosis rate, coxa vara rate, transient foot drop rate, temporary loss of scrotal sensation rate |
Yun, 2010 [22] | China | Case series | 40 (25–60) | 57.9 | Femoral neck fractures | NA | Traffic accident, fall from height, and combined injury | Garden stage II, III | 38 | Quadratus femoris muscle pedicle bone graft with screw fixation | 24–60 | Nonunion rate, avascular necrosis rate, effective rate |
Vallamshetla, 2010 [23] | India | Retrospective study | 34 (24–51) | 66.7 | Ununited intracapsular femoral neck fractures | NA | NA | NA | 42 (14 females) | Quadratus femoris muscle pedicle bone grafting | 63 (36–84) (range, 3–7 years) | Nonunion rate, failures rate, infection rate, varus union rate, avascular necrosis rate |
Bhuyan, 2012 [21] | India | Case series | 32.9 (20–53) | 66.7 | Neglected intracapsular femoral neck fracture | Associated injuries | Road traffic accident, fall from height | NA | 48 | Tensor fascia latae muscle pedicle bone grafting | 52.8 (24–81.6) | Nonunion rate, avascular necrosis rate, coxa vara rate, effective rate |
Zha, 2014 [18] | China | Non-randomized control | 41.98 ± 6.8 | 70 | Garden III/IV femoral neck fracture | NA | NA | Garden stage III, IV | 30 | Quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation | 6 | Nonunion rate, avascular necrosis rate, collapse rate, effective rate |
Mishra, 2014 [20] | India | Retrospective study | 38 (15–51) | 66.7 | Neglected femoral neck fracture | Associated injuries | Road traffic accident, slip on the ground while walking and fall from the height | Garden stage III, IV | 36 | Triple muscle (sartorius, tensor fascia latae, and part of gluteus medius) pedicle bone grafting | 54 (24–168) | Nonunion rate, coxa vara rate, avascular necrosis rate, effective rate |
Nair, 2014 [19] | India | Case series | 26.69 (15–45) | 82.4 | Neglected and ununited femoral neck fracture | Neck resorption | Road traffic accident, fall from height | NA | 17 | Quadratus femoris muscle pedicle bone grafting along with open reduction and internal fixation (ORIF) | NA | Shortening rate, coxa vara rate, effective rate (PMA scoring) |
Zhang, 2015 [17] | China | Case-control study | 37.8 ± 6.9 | 76.9 | Garden III/IV femoral neck fracture | NA | Traffic accident, fall from height and other | Garden stage III, IV | 26 | Quadratus femoris bone flap transplantation | 32 (28–41) | Nonunion rate, Harris hip score, avascular necrosis rate |
Baksi, 2016 [16] | India | Case series | 43.3 (16–55) | 54.1 | Ununited femoral neck fracture | NA | NA | NA | 244 | Internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting | 150 (36–420) | Nonunion rate, coxa vara rate, Harris hip score, hip motions, avascular necrosis rate |
Salgotra, 2016 [15] | India | Case series | 47 (38–55) | 85.7 | Delayed femoral neck fractures | NA | NA | Subcapital fractures or transcervical | 7 | Muscle-pedicle bone grafting with tensor fascia lata | 36 | Nonunion rate, collapse rate, total hip replacement rate, modified Harris hip score |
Tuzun, 2020 [14] | Turkey | Case series | 36.3 (19–58) | 56.3 | Ununited femoral neck fractures | Atrophy | Traffic accident, fall from height | NA | 16 | Quadratus femoris muscle pedicle bone grafting | 24 | Avascular necrosis rate, reoperation rate, Harris hip scores |