吻合血管腓骨移植治疗股骨头缺血坏死

A REPORT ON TREATMENT OF AUASCULAR OSTEONECROSIS OF FEMORAL HEAD WITH IMPLANTATION OF VASCULARIZED FIBULA GRAFT

临床观察吻合血管腓骨移植治疗成人股骨头缺血坏死520例，其中有创伤史229例，服用激素药物史者228例，有酗酒史者34例，原因不明者29例。术后315例获得1～15年随访，结果提示，优良率为86．6％。手术切开说关节囊，在彻底清除股骨头内骨坏死囊变组织的同时，植入新鲜自体松质骨并在股骨头颈部前外侧植入吻合血管的腓骨。该手术增加了股骨头部血液供给，充分减轻了股骨头内压力，加之腓骨为坚质骨，来后不易吸收，对股骨头颈部起到了支撑作用，防止了股骨头进一步塌陷。

520 patients affected by osteronecro-sis of the femoral head were clinically observed who received the treatment of implanting a vascularized fibula graft. The cause of the desease was related to trama in 229 patients. 228 patients had histories of steroid therapy. 34 patients had histories of alcohol abuse and in the 29 patients the deseas was idiopath- ic. 315 patients were followed up ranging from 1 to 15 years. The pecentage of clinically satisfactory re-sults, includinR Rood and excellent, was 86-6%.The main process of operation is opening joint cap-sule, eliminanting the cystic tissue, cancellous bone grafting and implanting a vascularized fibula in the anterio-lateral site of the femoral neck. The proce-dure was develped to promote healing of famoral head necrosis by providing blood supp1y to affected femoral head, reduce intraosseous pressure, en-hance formation of solid callus to support the femoral neck and prevent the articular surface from further collaps.