带血管髂骨瓣移植治疗股骨头缺血性坏死

Treatment of avascular necrosis of femoral head by grafting iliac bone flap with deep iliac circunmflex vessel

目的 介绍带旋髂深血管骨瓣移植治疗Ⅱ、Ⅲ期股骨头无菌性坏死的方法和临床效果。方法 清除坏死股骨头囊肿、死骨后，采用显微外科技术切取同侧带旋髂深血管骨瓣植入股骨头内。自2001年以来采用本方法治疗青壮年股骨头无菌性坏死12例。结果 经1-3年随访，术后6个月扶拐下床行走，9个月植入股骨头骨块愈合，全部病例均无发生股骨头塌陷。1年后10例正常行走，优良率占83．3％，2例遗留轻度关节疼痛或关节活动受限。结论 该手术方式选取骨瓣血管解剖位置恒定，手术操作简便，对供区生理影响小，适用于中青年早期股骨头无菌性坏死的治疗。

Objective To report a curative method and outcome of avascular necrosis of femoral head by grafting iliac bone flap with deep lilac circunmflex vessel. Methods Homolateral bone flap with deep iliac circunmflex vessel was transplanted into the defect after clearing up cysts and sequestra of femoral head. Twelve cases of adolescent avascular necrosis of femoral head received this operation program. Results All cases were followed up 1 -3 years, the patients could walk with the assistance of cane 6 months after operation and the flaps reached bony union 9 months postoperation. Ten cases walked normally 1 year postoperation,the result was excellent in 83. 3%. Slight arthralgia or articular dyskinesia was left over in 2 cases. Conclusion The anatomic site of flap is constant. Operational procedures are simple and there are minor effect to the donor site. This operation program is appropriate for the treatment of adolescent avascular necrosis of femoral head.