带血管腓骨插入式支撑植骨重建股骨头颈部破坏性病损

The Reconstruction of Destructive Bone Defect of Femoral Head-Neck with Implanting Vascular Fibular Graft

目的 :研究应用经大转子带血管腓骨移植治疗股骨头颈部破坏性病损的疗效。方法 :采用经大转子插入带血管腓骨移植和腔隙游离植骨方法治疗股骨头颈部破坏范围较大的肿瘤和肿瘤样变 2 8例 ,其中 13例合并病理性骨折。结果 :随诊 1.5～ 4年 ,2 7例治愈 ,1例复发 ,2例合并股骨头缺血坏死 ,优良率为 89.2 %。结论 :腓骨为坚质骨 ,术后不易吸收 ,其柱状支撑作用可以提高股骨颈的抗折力 ,预防和治疗股骨颈病理性骨折 ,早期恢复髋关节功能和下肢负重 ,减少复发。

Objective:To study the therapeutic effect of ped icled fibular grafting through the great trochanter for treating bone destructiv e defect of femoral head-neck.Methods:Twenty-eight cases of benign tumor and n eoplastic lesion of femoral head-neck extensively destroied were treated with p edicled fibular grafting through the great trochanter and free bone grafting.Of the 28 cases,13 were complicated with pathological fracture.Results:Through 1～4 years follow-up,the results were cured in 27 cases,recurrent in I and complica ted with femoral head necrosis in 2.The excellent-good rate reached 89.2%.Concl usion:The fibula is compact bone and hardly to be absorbed after operation.Howe ver,it has a columnar supporting effect,which improves the anti-bending strengt h of the femoral neck to prevent the pathological fracture.This method promises recovery of the function of the hip and the weightbearing of the lower extremity ,and decrease the recurrence of lesiom.