吻合血管腓骨移植治疗陈旧性股骨颈骨折(英文)

Treatment of Non-union Femoral Neck Fractures with Vascularized Fibula Grafting

目的:了解吻合血管腓骨移植治疗陈旧性股骨颈骨折和预防股骨头坏死的效果。方法:带血管腓骨移植到股骨颈的前外侧,腓动静脉与旋股外动静脉吻合。结果:1982～2002年间共吻合血管腓骨移植治疗陈旧性股骨颈骨折129例。获得随访89例,随访时间3～19年,随访患者进行X线和功能检查。按骨折愈合和功能情况分析,有效率和良好率分别是95.4％和85.1％。结论:对股骨颈骨折,腓骨有协同固定作用,对股骨头坏死腓骨作为皮质骨有支撑和防止塌陷的作用,吻合的腓骨血管为股骨头颈部提供血供,促进了股骨颈骨折的愈合和股骨头的恢复与重建。腓骨骨膜在骨折的愈合中可能起一定的作用。

Objective: To investigate the value of transplantation of vascularized fibula in treating non-union femoral neck fractures and preventing ischemic necrosis of the femoral head. Methods : Vascularized heterotopic fibula was transplanted to the anterior-lateral part of the femoral neck. The fibula artery and vein were anastomosised with lateral circumflex artery and vein. Results : One hundred and twenty-nine cases of non-union femoral neck fracture were treated with vascularized fibula graft in our hospital from 1982 to 2002. Eighty-seven cases of them were followed up for 3 to 19 years with functional and X-ray examination. The percentage of fracture healing and effect were 94. 3 and 81. 6, respectively. Conclusion:The fibula with blood supply has a synergistic fixation impact on the non-union femoral neck fractures. The fibula is solid enough for supporting the femoral head and preventing it from collapse. The vascularized fibula grafting, by providing blood supply to the affected femoral head and neck, could promote the femoral head restoration and reconstruction. In addition, the periosteum of fibula plays a role in fracture healing.