带旋髂深血管蒂髂骨移植治疗中青年股骨头无菌坏死(附18例报告)

The Use of the Deep Circumflex Iliac Vessel Pedicle Bone Grafting for the Treatment of Aspetic Necrosis of the Femoral Head in Young and Middle Aged Patients

采用带旋髂深血管蒂髂骨瓣移植治疗中、青年股骨头无菌性坏死共18例21个髋。随访2年8个月,发现此术式对重建股骨头血运疗效,优良率为93.7％。手术采用改良的smith-peterson切口,术中对解剖血管,切除关节囊及滑膜、骨减压以及带血管蒂髂骨块转位移植均较为方便易行。且旋髂深血管管径粗,恒定,变异少,手术成功率高。术中应对股骨头减压彻底,要避免血管蒂扭曲,勿损伤圆韧带,应强调避免早期负重是防止股骨头塌陷的重要措施。

18 young and middle aged patients (21 hips)with aspetic necrosis of the femoral bead have been treated using the deep circumflex iliac vessel pedicle bone grafting. The follow-up of two years and eight months showed good results in 93.7％ and it has proved really effective for the blood circulation re-building of the femoralhead. The operation uses the improved Smith-Peterson incision, which is very con-vinient for dissecting vasa, resecting capsulatomy and synovialis as well as reducing the intraosseous pressure and implanting vascular pedicle bone. As the deep circumflex iliac vessels are generally thick and un-changable, the operation has, therefone, a higher rate of success. However, during operation, the intraosseous pressure showld be redced thoroughly. Try not to spring vascular pedicle or injure femoral head liga-ment. Also avoid putting weihgt on the operated hip too early, which is very critical for the prevention of the collapse of the femoral head.