吻合血管腓骨移植重建股骨头血供实验研究

EXPERIMENTAL STUDY ON REESTABLISHMENT OF THE BLOOD SUPPLY TO THE FEMORAL HEAD BY FREE FIBULAR GRAFT WITH MICROVASCULAR ANASTOMOSIS

本文采取自身对照方法对18条成熟体健雄性家犬的36侧股骨头颈部、分为两组、分别制成陈旧性股骨颈骨折和股骨头缺血性坏死模型。两周后进行吻合血管腓骨移植,术后分别进行X线片、病理组织学、电镜、99~m锝-亚甲基二膦酸盐骨扫描和四环素荧光标记等观察。实验结果表明:吻合血管腓骨移植为损伤股骨头提供了新的血供系统。坚硬的游离腓骨和金属内固定同时插入股骨头颈部,术后腓骨在骨折区形成骨桥,不仅能消除剪力,而且防止骨折断端旋转移位。移植腓骨骨膜也参与了股骨头缺血性坏死的修复过程。

The authors adopted an auto control experimental research on 18 male adult dogs with 36 sides of femoral heads and necks which were divided into two groups. They were separately made models of old fracture of femoral neck and avascular necrosis of famoral head. Two wecks later, The free fibula with microvascular an astomosis was tranplanted. All experimental dogs were examined with X-ray, pathohitology, electron microscopy, 99~mTc-MDP scanning and tetracycling labeling after operation.The experiment showed that the free fibular graft with mierovascular anastomosis could provided a new system of vascula supply to the injured femoral head. The hard free fibula and the metallic internal fixation were inserted in femoral head and neck. After the Operation, in the fracture area the fibula formed a bone-bridge which not only diminished the stress force but also prevented rotation displacement of the bone fracture The periosteum of the transplanted fibula also took part in the repair course of avascular nerosis of femoral head.