Femoral head necrosis often occurs in young adults and has a high rate of disability. If the disease is not treated in a timely manner, it will lead to loss of working capacity and bring a great burden to the family and society. However, there is no specific medicine that can cure femoral head necrosis, and surgery is the only effective treatment method. In order to save the necrotic femoral head, surgical intervention should be performed as early as possible to stop or delay the further development of femoral head necrosis. The most common causes of femoral head necrosis are: trauma, alcohol abuse, and hormone use. However, no matter what the causes of femoral head necrosis are, they all have the same pathological changes, and they are all due to necrosis of the femoral head as a result of impaired blood supply. Therefore, the treatment of femoral head necrosis needs to focus on how to restore and increase the blood supply to the femoral head. Femoral head necrosis should be diagnosed early and treated with surgery early. The earlier the treatment, the greater the possibility of saving the femoral head. In advanced stages, when the femoral head is already severely collapsed and arthritic, only artificial joint replacement can be performed. Although current artificial joint replacement technology is very mature, artificial joints have an expiration date and are not the best treatment option. For the elderly, the 20-year survival rate of artificial joints is more than 85%, which is a more than ideal treatment method. For young adults, the life expectancy of the prosthesis after artificial joint replacement is much lower than that of the elderly, due to the fact that the activities of young adults are significantly more active than those of the elderly, and the artificial joints wear out more quickly. For younger patients with femoral head necrosis, if they choose to have an artificial hip replacement, they will have to have at least 1-2 more artificial joint revision surgeries. The artificial joint revision surgery is much more difficult than the initial hip replacement, and the cost is twice or more than the initial hip replacement, and the complications of the surgery are also much higher than the initial surgery. Therefore, for young adults with femoral head necrosis, the femoral head should be saved as much as possible to prolong the life of the femoral head, so that the age of joint replacement can be postponed, and artificial joint replacement cannot be used for all cases of femoral head necrosis. The main procedures to save the femoral head are medullary decompression, medullary decompression + bone grafting (without hematopoietic bone), medullary decompression + live bone grafting (with hematopoietic bone), and tantalum metal rod placement. Among them, medullary decompression + live bone grafting has the best results and the highest success rate. Live bone grafting includes localized bone flap grafting with blood flow and free fibula grafting with blood vessels. Live bone grafting targets the pathological basis of femoral head necrosis, because femoral head necrosis is caused by ischemia, and live bone grafting can bring blood flow to the femoral head, and the transplanted bone can heal quickly with the femoral head. Free fibula graft with blood vessels is the best method among all living bone grafts. The fibula is a tubular cortical bone with high strength, which brings new blood flow to the femoral head and provides strong support to the femoral head that is about to collapse, preventing it from collapsing. The fibula is a thinner bone on the calf, its role is mainly involved in the composition of the ankle joint, bearing only 1/6 of the body weight, and has little effect on the function of the calf after it is cut 10 cm above the ankle joint. The procedure is mainly: 1) scraping out all the necrotic bone and fibrous tissue from the femoral head through the femoral neck bone tunnel; 2) cutting a section of fibula, preserving the periosteum and blood vessels (fibular artery and vein) on the fibula when cutting the fibula; 3) expanding the tunnel of the femoral neck according to the diameter of the fibula, so that the diameter of the tunnel is slightly larger than the diameter of the fibula; 4) inserting the fibula into the tunnel, with the distal end of the fibula topped by the cartilage of the femoral head (usually about 0.5 mm), and a steel pin is used to lock the proximal end of the fibula to the femur to prevent the fibula from moving; 5) the blood supply vessels of the fibula are anastomosed to the selected lateral femoral vessels.