吻合血管的骨膜瓣和筋膜瓣联合移植治疗难治性骨不连  

The experimental study and clinical application in the treatment of problematic nonunion with vascularized periosteal and fascial flaps

作　　者：范启申[1] 徐林[1] 周详吉[1] 郭德亮[1] 魏海温[1] 

机构地区：[1]解放军第89医院全军骨科中心,山东潍坊261021

出　　处：《实用手外科杂志》2002年第1期29-31,F003,共4页Journal of Practical Hand Surgery

摘　　要：目的　探讨吻合血管的骨膜瓣和筋膜瓣联合移植治疗骨不连的疗效。方法　先预制家兔骨不连动物模型 ,将 5 4只随机分为三组 ,每组 18只。A组单纯用带血管的骨膜瓣包绕骨折端 ;B组单纯用带血管的筋膜瓣同法处理 ;C组 (实验组 )两者联合应用。术后 1、 2、 4、 8周分别行大体观察、X线、组织学及碱性磷酸酶检查。并在实验研究的基础上临床应用 6 3例。结果　C组愈合时间较A、B组早 1～ 2周 ,且愈合率明显高于A、B两组 ,临床X线随访 :2个月大量骨痂生长 ,3 5～ 4 5个月骨折线基本消失。Objective To explore the clinical effect of vascularized periosteal and fascial flaps in the treatment of problematic nonunion.Methods Fifty four adult rabbits were induced nonunion of the femur and randomly divided into three groups.Group A:The fracture site were treated with vascularized periosteal flaps.Group B:The fracture site were treated with vascularized fascial flaps.Group C:The fracture site were treated with both vascularized periosteal and fascial flaps.Based on the experimental results,63 cases were applied in clinic.Results The fracture healing time of Group C was much earlier than Group A and B about 1～2 weeks,and the rate of fracture healing of Group C was much higher than Group A and B.In clinical application,63 cases were all followed up by X ray.A lot of callus were found two months after operation,and the fracture line fundamentally disappeared 3 5～4 months after operation.Conclusion Vascularized periosteal and fascial flaps was an effective and feasible method in the treatment of problematic nonunion.

关 键 词：难治性骨不连 骨膜瓣 筋膜瓣 吻合血管 联合移植 骨折 

分 类 号：R687.3[医药卫生—骨科学]