Varanasi: Department of orthopaedics, Institute of Medical Sciences (IMS), BHU performed a complex orthopaedic reconstructive surgery using vascularised fibular grafting for avascular necrosis of the femoral head in an 18-year-old girl under supervision of Prof Shivam Sinha, along with Dr Sudipto Bera, Dr Rohit Rai, Dr Digvijaysingh Sindhav and Dr Rahul Rai.Prof Sinha said the girl, resident of Buxar (Bihar) had avascular necrosis (AVN) of the head of the femur following trauma and fixation two years back. She had difficulty walking and was in pain for two years. Considering her age, total hip replacement was not a viable option, as experts denied it and deemed it to necessitate advanced reconstructive management. Due to sudden injury on the hip, vascular supply was hampered and the hip underwent ischaemic damage, destroying the joint. This AVN condition is common in fractures around the hip (intra-articular), alcoholics and drug-induced cases.Restoration of blood supply could regenerate the bone cells; thus, considering the complexity of the case, the surgical team opted for vascularised fibular grafting, a specialised technique commonly used for defects and restoration of limb function. The 6-hour-long procedure involved harvesting a segment of the fibula bone along with its blood supply by plastic surgeons, subsequently transplanting it into the femoral head by orthopaedic surgeons. The surgery was completed successfully and the patient is currently stable and recovering under close postoperative care, moving with the help of a walker.
