吻合血管腓骨移植治疗陈旧性股骨颈骨折  

Treatment of old femoral neck fracture with implantation of a vascularized fibular graft

作　　者：王坤正[1,2,3] 党晓谦[1,2,3] 武永刚 刘安庆[1,2,3] 雷高 李旭东[1,2,3] 高喜明 杨大志 

机构地区：[1]西安医科大学第二附属医院骨科 [2]内蒙古巴彦淖尔盟医院骨科 [3]西安铁路中心医院显微外科

出　　处：《中华外科杂志》1998年第5期261-263,T057,共4页Chinese Journal of Surgery

摘　　要：目的应用吻合血管腓骨移植和加压螺丝钉内固定治疗陈旧性股骨颈骨折，观察股骨颈骨折的愈合和股骨头缺血坏死的修复和预防状况。方法在加压螺丝钉内固定的基础上，取自体带血管腓骨，移植在股骨头颈部的前外侧，腓骨动静脉与旋股外动静脉吻合。结果１８６例患者经３～１５年的系统Ｘ线片和功能随访观察，骨折愈合率为９３．０％，优良率达８６．５％。结论带血管腓骨和加压螺丝钉对陈旧性股骨颈骨折形成协同固定作用，腓骨坚硬，不易吸收，支撑在股骨头内防止塌陷，为股骨头颈部提供了新的血供，有利于股骨头的修复与重建。Objective To investigate the healing of old femoral neck fracture treated with transplantation of vascularized fibula graft accompanied with lag screw,and rehabilitation of and precaution against ischemic necrosis of femoral head.Method Vascularized fibula autograft was transplanted to the anterolateral side of the femoral neck with an internal fixator of lag screw.Fibular artery and vein were anastomosed with lateral circumflex artery and vein.Result 186 of 229 cases subjected to systemic X ray films and function follow up (3 to 15 years).The percentage of fracture healing was 93 0% the sulass rate 86 5%.Conclusion Fibula with blood supply and compressed screw have a combined fixation effect of the old femoral neck fracture.Fibula is solid enough for supporting the femoral head and preventing it from collapse.Vascularized fibular grafting provides blood supply to the affected femoral head and neck, promoting femoral head restoration and reconstruction.

关 键 词：股骨颈骨折 吻合术 腓骨移植 

分 类 号：R683.420.5[医药卫生—骨科学]