阔筋膜张肌臀中肌间隙入路带血管蒂大转子骨瓣治疗股骨头坏死  

Treatment of avascular necrosis of femoral head by greater trochanter bone flap vascular pedicle vessel through the interspace between tensor fasciae latae and gluteus medius

作　　者：朱红伟[1] 张少成[1] 张燕鹏[2] 陈伟南[3] 党瑞山[4] 张传森[4] 

机构地区：[1]第二军医大学长海医院骨科,上海200433 [2]复旦大学附属华山医院宝山分院骨科,上海200431 [3]解放军101医院骨科,无锡214044 [4]第二军医大学解剖学教研室,上海200433

出　　处：《解剖学杂志》2010年第3期373-376,共4页Chinese Journal of Anatomy

摘　　要：目的：探讨经阔筋膜张肌臀中肌间隙入路带旋股外侧动脉横支大转子骨瓣修复股骨头坏死的解剖学基础，总结用该术式治疗股骨头坏死的临床经验。方法：在尸体解剖和模拟手术的基础上，对28例股骨头坏死患者施行阔筋膜张肌臀中肌间隙入路带血管蒂大转子骨瓣手术。结果：28例成功完成股骨头坏死病灶清除带旋股外侧动脉横支大转子骨瓣移植＋钽棒内固定术。平均切口长度9．3cm，平均手术时间60min；平均术中出血量260ml，术中输血3例，均为200ml。结论：阔筋膜张肌臀中肌间隙入路行股骨头坏死修复术切口小，组织损伤轻，出血少，显露良好、操作方便。Objective： To discuss the anatomical basis and summarize the clinical experience of repairing femoral head necrosis by vascularized greater trochanter bone grafts via the interspace between gluteus medius and tensor fasciae latae. Methods： On the basis of autopsy and simulation operation in the specimens, the surgery with vascularized greater trochanter bone grafts necrosis via the interspace between gluteus medius and tensor fasciae latae was performed on 28 patients. Results： 28 patients of avascular necrosis of femoral head were performed with focal cleaning, vascularized bone flap graft and tantalum rod insertation via the approach, the mean incision length, operation time, blood loss was 9.3 cm, 60 minutes, 260 ml, respec- tively. Only 3 patients had 200 ml blood transfusion during operation. Conclusion： Treatment of avascular necrosis of femoral head by vaseularized greater trochanter bone grafts via the interspace between gluteus medius and tensor fasciae latae has many advantages, such as mini-incision,less tissue trauma, less bleeding and better exposure, and is facilitated to perform operation.

关 键 词：股骨头坏死 大转子骨瓣 旋股外侧动脉横支 钽棒 手术入路 

分 类 号：R681.8[医药卫生—骨科学]