{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:48:04Z","timestamp":1787755684051,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Old femoral neck fracture (OFNF) generally refers to fractures for more than 3 weeks. Corticoperiosteal pedicle flap of greater trochanter (CPPF-GT) was designed to restore blood supply and donor bone for OFNF. This study aimed to assess the efficacy and radiographic results of CPPF-GT for treatment of OFNF in children after a minimum 5 years follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Twenty-three patients with OFNFs, age from 8 to 16 years old, who underwent open reductions, fracture fixations, and transpositions of CPPF-GTs were retrospectively reviewed. Clinical and radiological outcomes, including union, nonunion, avascular necrosis of femoral head, limb shortening, coxa vara, premature epiphyseal closure and Ratliff\u2019s assessment, were investigated in the postoperative follow-up. The results were compared with previously published joint-salvage study of OFNFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All patients were followed for an average of 5.9 years (range: 5 to 10 years). All cases (100%) achieved hip unions at an average duration of 3.5 months (range: 2.5 to 5 months). No nonunion hip was observed. Three hips (13.0%) progressed to avascular necrosis of femoral head after 1.5 to 3 years of operation, respectively, and the revision surgeries to hip replacements were conducted. Premature epiphyseal closures were observed in 3 hips. Three hips visibly presented an average 2 cm shortening of the femoral neck. Coxa vara deformities were observed in 2 hips. According to the Ratliff\u2019s criteria, there were 20 cases (87.0%) with satisfactory union, good results were achieved in 17 cases, fair results in 3 cases, and poor result in 3 cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Corticoperiosteal pedicle flap of greater trochanter is an effective and desirable option for treating old femoral neck fractures in children with a low rate of avascular necrosis and without nonunion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.20.00484","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T15:17:24Z","timestamp":1634743044000},"page":"61-67","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Corticoperiosteal Pedicle Flap of Greater Trochanter for Salvage of Old Femoral Neck Fracture in Children"],"prefix":"10.2106","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4375-3814","authenticated-orcid":false,"given":"Chao","family":"Jian","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Trauma and Microsurgery, Zhongnan Hospital of Wuhan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0245-1126","authenticated-orcid":false,"given":"Baiwen","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Trauma and Microsurgery, Zhongnan Hospital of Wuhan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5723-6140","authenticated-orcid":false,"given":"Aixi","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Trauma and Microsurgery, Zhongnan Hospital of Wuhan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"issue":"12","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"411","DOI":"10.5435\/JAAOS-D-16-00362","article-title":"Management of Pediatric Femoral Neck Fracture","volume":"26","author":"Patterson","year":"2018","journal-title":"J Am Acad Orthop Surg."},{"issue":"Suppl 8","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1097\/BOT.0000000000001645","article-title":"Femoral Neck Fractures in Children: Issues, Challenges, and Solutions","volume":"33","author":"Barreto Rocha","year":"2019","journal-title":"J Orthop Trauma."},{"issue":"1","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1302\/1863-2548-11-160221","article-title":"Fibular strut graft for nonunited femoral neck fractures in children","volume":"11","author":"Elgeidi","year":"2017","journal-title":"J Child Orthop."},{"issue":"4","key":"bib4-20250430","first-page":"208","article-title":"[Applied anatomy of repairing neck of femur with greater trochanter flap]","volume":"6","author":"Dou","year":"1988","journal-title":"Chin J Clin Anat."},{"issue":"4","key":"bib5-20250430","first-page":"233","article-title":"[A preliminary report of clinical application of pedicled greater trochanter flap transposition]","volume":"8","author":"Chen","year":"1990","journal-title":"Chin J Clin Anat."},{"issue":"5","key":"bib6-20250430","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1055\/s-0031-1278709","article-title":"Treatment of serious femoral neck fractures with the transposition of vascularized greater trochanter bone flap in young adults","volume":"27","author":"Pan","year":"2011","journal-title":"J Reconstr Microsurg."},{"issue":"5","key":"bib7-20250430","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1007\/s11999-009-1159-1","article-title":"Will a vascularized greater trochanter graft preserve the necrotic femoral head?","volume":"468","author":"Zhao","year":"2010","journal-title":"Clin Orthop Relat Res."},{"issue":"6","key":"bib8-20250430","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/S0002-9610(29)90726-1","article-title":"Fracture of the neck of the femur in children","volume":"6","author":"Colonna","year":"1929","journal-title":"Am J Surg."},{"issue":"4","key":"bib9-20250430","first-page":"304","article-title":"[The treatment of ischemic necrosis of femoral head with vascularized great trochanter periosteal flap transposition in children]","volume":"16","author":"Chen","year":"1999","journal-title":"Chin J Exp Surg."},{"key":"bib10-20250430","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1302\/0301-620X.44B3.528","article-title":"Fractures of the neck of the femur in children","volume":"44-B","author":"Ratliff","year":"1962","journal-title":"J Bone Joint Surg Br."},{"issue":"3","key":"bib11-20250430","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/00005131-199209000-00007","article-title":"Fibular osteosynthesis for delayed type II and type III femoral neck fractures in children","volume":"6","author":"Nagi","year":"1992","journal-title":"J Orthop Trauma."},{"issue":"4","key":"bib12-20250430","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/BOT.0b013e31804cfdad","article-title":"Modified Pauwels' intertrochanteric osteotomy in neglected femoral neck fractures in children: a report of 10 cases followed for a minimum of 5 years","volume":"21","author":"Magu","year":"2007","journal-title":"J Orthop Trauma."},{"issue":"2","key":"bib13-20250430","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s11832-008-0078-0","article-title":"Nonunion of fractures of the femoral neck in children","volume":"2","author":"Neto","year":"2008","journal-title":"J Child Orthop."},{"issue":"14","key":"bib14-20250430","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.2106\/JBJS.18.01132","article-title":"Vascularized fibular grafting in treatment of femoral neck nonunion: a prognostic study based on long-term outcomes","volume":"101","author":"Yin","year":"2019","journal-title":"J Bone Joint Surg Am."},{"issue":"152","key":"bib15-20250430","first-page":"49","article-title":"Postfracture avascular necrosis of the femoral head: correlation of experimental and clinical studies","author":"Calandruccio","year":"1980","journal-title":"Clin Orthop Relat Res."},{"issue":"7","key":"bib16-20250430","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1302\/0301-620X.86B7.15047","article-title":"Delayed internal fixation of fractures of the neck of the femur in young adults. A prospective, randomised study comparing closed and open reduction","volume":"86","author":"Upadhyay","year":"2004","journal-title":"J Bone Joint Surg Br."},{"issue":"12","key":"bib17-20250430","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1302\/0301-620X.98B12.BJJ-2016-0251.R1","article-title":"The relative contribution of the medial and lateral femoral circumflex arteries to the vascularity of the head and neck of the femur: a quantitative MRI-based assessment","volume":"98-B","author":"Dewar","year":"2016","journal-title":"Bone Joint J."},{"issue":"5","key":"bib18-20250430","doi-asserted-by":"crossref","first-page":"250","DOI":"10.3928\/01477447-20190723-03","article-title":"Femoral head vascularity: implications following trauma and surgery about the hip","volume":"42","author":"Gadinsky","year":"2019","journal-title":"Orthopedics."},{"issue":"6","key":"bib19-20250430","doi-asserted-by":"crossref","first-page":"475","DOI":"10.2106\/JBJS.15.00367","article-title":"A vessel-preserving surgical hip dislocation through a modified posterior approach: assessment of femoral head vascularity using gadolinium-enhanced MRI","volume":"98","author":"Sculco","year":"2016","journal-title":"J Bone Joint Surg Am."},{"issue":"8","key":"bib20-20250430","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1002\/micr.22114","article-title":"Treatment of osteonecrosis of the femoral head by using the greater trochanteric bone flap with double vascular pedicles","volume":"33","author":"Wang","year":"2013","journal-title":"Microsurgery."},{"issue":"8","key":"bib21-20250430","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1002\/micr.22179","article-title":"Digital subtraction angiography in selection of the vascularized greater trochanter bone grafting for treatment of osteonecrosis of femoral head","volume":"33","author":"Zhao","year":"2013","journal-title":"Microsurgery."},{"issue":"Suppl 3","key":"bib22-20250430","doi-asserted-by":"crossref","first-page":"S66","DOI":"10.1016\/S0020-1383(17)30661-7","article-title":"The treatment of long bones nonunions of upper limb with microsurgical cortico-periosteal free flap","volume":"48","author":"Guzzini","year":"2017","journal-title":"Injury."},{"issue":"4","key":"bib23-20250430","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1097\/CORR.0000000000000400","article-title":"Vascularized periosteal flaps accelerate osteointegration and revascularization of allografts in rats","volume":"477","author":"Gallardo-Calero","year":"2019","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib24-20250430","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.bone.2004.07.014","article-title":"Periosteum: biology, regulation, and response to osteoporosis therapies","volume":"35","author":"Allen","year":"2004","journal-title":"Bone."},{"issue":"5","key":"bib25-20250430","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1002\/micr.1920150505","article-title":"Vascularized periosteal bone graft from the supracondylar region of the femur","volume":"15","author":"Doi","year":"1994","journal-title":"Microsurgery."},{"issue":"1","key":"bib26-20250430","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1002\/micr.20439","article-title":"The treatment of displaced femoral neck fractures with vascularized great trochanter periosteal flap transposition in children","volume":"28","author":"Qi","year":"2008","journal-title":"Microsurgery."},{"issue":"2","key":"bib27-20250430","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1302\/0301-620X.39B2.358","article-title":"The normal vascular anatomy of the human femoral head during growth","volume":"39-B","author":"Trueta","year":"1957","journal-title":"J Bone Joint Surg Br."},{"issue":"6","key":"bib28-20250430","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s11832-009-0209-2","article-title":"Delayed fixation of the transcervical fracture of the neck of the femur in the pediatric population: results and complications","volume":"3","author":"Dhar","year":"2009","journal-title":"J Child Orthop."},{"issue":"9","key":"bib29-20250430","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1302\/0301-620X.101B9.BJJ-2019-0275.R1","article-title":"Risk factors for the development of avascular necrosis after femoral neck fractures in children: a review of 239 cases","volume":"101-B","author":"Wang","year":"2019","journal-title":"Bone Joint J."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.20.00484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:46:33Z","timestamp":1787751993000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.20.00484"}},"subtitle":["Outcomes After a Minimum 5 Years Follow-up"],"short-title":[],"issued":{"date-parts":[[2021,10,18]]},"references-count":29,"journal-issue":{"issue":"Suppl 2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.20.00484","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,18]]}}}