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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Femur Head Getting Less Blood Supply Due To Screw Fixation. How To Increase Supply?

Hi, I have been gone through Hip pinning few years back and had screws fixation between my femur head and femur bone because of a fracture , and now i am facing a problem in which my femur head is getting less supply which had caused variation in length of legs and degeneration of femur head. Please suggest me what is needed to increase the blood supply in that particular region.
Mon, 22 Jul 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

From the description, I understand that your femoral neck fracture was fixed with cancellous screws. The standard teaching and practice for these fractures in internal fixation with screws to promote osteosynthesis.

Unfortunately, the risk of AVN (Avascular necrosis) is very high in these fractures which results in pain, leg length discrepency and collapse of femoral head.

There are few surgical procedures that promote increased blood supply to femoral neck and head like Myer's muscle pedicle bone graft, Vascularised fibular graft etc. But these surgeries will not yield consistent results and are technically demanding.

The easiest way to deal is either a BIPOLAR ARTHROPLASTY or a TOTAL HIP REPLACEMENT surgery.

Hope this information is helpful. Good day
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General & Family Physician Dr. Het Ram Bishnoi 's  Response
Hello
Thanks for the query to H.C.M. Forum.
As screw is interfering in blood supply to femur head and it also causing degeneration , so the best way is get it remove the screw after consultation with your doctor.
As this was for femur fracture and in my opinion fractured femur site has cured .
In my opinion now screw is useless , so removal surgery is best option.
Consult your doctor and take his advice.
Good luck.
Dr. HET
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Femur Head Getting Less Blood Supply Due To Screw Fixation. How To Increase Supply?

Hi, thanks for writing to HCM. From the description, I understand that your femoral neck fracture was fixed with cancellous screws. The standard teaching and practice for these fractures in internal fixation with screws to promote osteosynthesis. Unfortunately, the risk of AVN (Avascular necrosis) is very high in these fractures which results in pain, leg length discrepency and collapse of femoral head. There are few surgical procedures that promote increased blood supply to femoral neck and head like Myer s muscle pedicle bone graft, Vascularised fibular graft etc. But these surgeries will not yield consistent results and are technically demanding. The easiest way to deal is either a BIPOLAR ARTHROPLASTY or a TOTAL HIP REPLACEMENT surgery. Hope this information is helpful. Good day