带旋髂深血管蒂髂骨瓣移植治疗成人股骨头缺血性坏死及疗效分析

Grafting of Iliac Bone With the Deep Circumflex Iliac Vessel Pedicle for the Treatment of Avascular Necrosis of Femoral Head and Clinical Evaluation

目的 回顾分析旋髂深血管蒂髂骨瓣移植治疗股骨头缺血性坏死的疗效 ,探讨其临床应用的价值。方法 采用滑膜切除、开窗减压、病灶刮除后带旋髂深血管蒂骼骨块植骨。结果 随访 0 5～ 5年 ,优良率84 4 %。股骨头无进一步塌陷 ,已塌陷者有不同程度修复和圆滑现象。结论 此手术方法适应于各种类型股骨头缺血性坏死Ⅰ、Ⅱ、Ⅲ期患者 ,对于部分年轻不宜行关节置换的晚期病例仍不失为一种有效方法 ,且不影响日后人工关节置换。

Objective To retrospect and probe the clinical applied value and the results of iliac bone with the deep circumflex iliac vessel transplantation for the treatment of avascular necrosis of femoral head.Methods With a composite procedure including synovectomy,fenestration,curettage and vascularized iliac bone graft with pedicle of the ipsilateral deep circumflex iliac vessels.Results Follow-up period average 2 years 8 months(range:for 6 month-5 years) and all patients were roentgenographied.According to new grading treatment system four items and six grades for avascular necrosis of femoral head was evaluated.Excellent and good rate was 84 4%.Post-operative radiological assessment demonstrated that there was no incidence of deterioration or further collapse of the femoral head and certain extent of re-sphering and re-surfacing of the head was observed in all of the collapsed heads.Conclusions The results of this study suggest that the technique is suitable for the treatment of avascular necrosis of femoral head of the stage Ⅰ Ⅱ Ⅲ and younger patients of late stage.