带血管蒂楔骨瓣联合髂骨植骨术治疗非创伤性距骨缺血性坏死  

Treatment of non-traumatic avascular talar necrosis by transposition of vascularized cuneiform bone flap plus iliac cancellous bone grafting

作　　者：于小光[1] 赵德伟[1] 孙强[1] 王铁男[1] 于海波[1] 苏云[1] 刘吉斌[1] 郑加法[1] 王本杰[1] 崔大平[1] 

机构地区：[1]大连大学附属中山医院骨科,116001

出　　处：《中华医学杂志》2010年第15期1035-1038,共4页National Medical Journal of China

基　　金：国家自然科学基金（30870647）

摘　　要：目的带血管蒂楔骨瓣转移联合髂骨植骨术治疗非外伤性距骨缺血性坏死并评价其疗效。方法自2000年1月至2005年6月，应用带血管蒂楔骨瓣转移治疗非外伤性距骨缺血性坏死20例，男14例，女6例；年龄22～58岁，平均42．5岁；按照改良的Ficatand Arlet分期标准，II期8例；III期10例；IV期2例。结果随访14～68个月（平均37个月），按Kenwright等的疗效标准进行评定，优8例；良10例；可1例；差1例。临床症状完全或部分缓解，术后骨坏死区全部被新生骨组织填充，术后优良率为90％。结论带血管蒂楔骨瓣转移髂骨植骨术是治疗非外伤性距骨缺血性的较为理想的方法，值得临床应用。Objective To evaluate the outcome of cancellous bone grafting plus iliac cancellous bone in the treatment of non-traumatic avascular talar necrosis. Methods Twenty patients, 14 males and six females, eight at stage II , ten at stage III and three at stage IV according to the modified Ficat＆ Arlet necrosis classification system, were treated with vascularized bone flap from January 2000 to June 2005. Results All patients were followed up for a mean of 37 months （ range ： 14 to 68 months ）. The clinical function outcome evaluated by Kenwright criteria were excellent in 8 cases, good in 10 cases, fair in 1 case and poor in 1 case. Clinical symptom was completely or partially relieved. The necrotic area was filled with newly formed bone and the excellent-to-good rate was 90%. Conclusion Transposition of vascularized cuneiform bone flap plus iliac cancellous bone grafting may be an ideal therapeutic method for non-traumatic avascular talar necrosis. And the clinical outcome is satisfactory.

关 键 词：骨坏死 距骨 移植 自体 

分 类 号：R687.3[医药卫生—骨科学]