带旋股外侧动脉升支髂骨骨膜瓣植入治疗儿童股骨头缺血性坏死  

The iliac periosteal flap with ascending branch of lateral femoral circumflex artery for the treatment of Legg-Calve-Perthes disease

作　　者：傅维民[1] 赵德伟[1] 王本杰[1] 马志杰[1] 王建川[1] 

机构地区：[1]大连大学附属中山医院骨科,辽宁省大连市116001

出　　处：《中华显微外科杂志》2015年第3期231-234,共4页Chinese Journal of Microsurgery

基　　金：国家临床重点专科建设项目[国卫办医函（2013）544号]

摘　　要：目的 探讨应用带旋股外侧动脉升支髂骨骨膜瓣植入治疗儿童股骨头缺血性坏死的临床效果及意义. 方法 分析自2008年1月至2012年5月在我院应用带旋股外侧动脉升支髂骨骨膜瓣植入治疗的18例患者资料.随访时间24-60个月,平均38个月,随访时间截止2014年5月.随访时行X线片检查并进行临床体格检查,Harris评分系统评估手术效果. 结果 X线见16例患者术后骨膜瓣愈合良好,骨骺高度逐渐恢复,股骨头变圆.2例股骨头出现变扁、塌陷.Mose法结合X线所得结果优良率为88.9％.Harris评分从术前平均（72.3±4.9）分提高到术后平均（91.3±2.4）分,两者比较差异有统计学意义（P＜0.05）. 结论 应用带旋股外侧动脉升支髂骨骨膜瓣植入是儿童股骨头缺血性坏死的一种有效治疗方法.Objective To investigate the clinical effect of the iliac periosteal flap with ascending branch of lateral femoral circumflex artery for the treatment of Legg-Calve-Perthes disease.Methods Followed-up 18 patients with Legg-Calve-Perthes disease who had undergone the treatment of iliac periosteal flap with ascending branch of lateral femoral circumflex artery from January,2008 to May,2012 in our hospital.Minimum follow-up time was from 24 to 60 months,and the average time was 38 months.The followed-up period ended in May,2014.Assessed the effect of surgery by X-ray,clinical examination and Harris scoring system.Results Sixteen patients had good healing with iliac periosteal flap according to X-ray show.Their epiphyseal height recovered and the femoral head rounded gradually.Two cases became flat and collapse.The result of excellent and good rate was 88.9% by Mose method combined with the results of X-ray.The average Harris hip score improved from 72.3 ± 4.9 points preoperatively to 91.3 ± 2.4 points postoperatively.The difference of the result was statistically significant （P 〈 0.05）.Conclusion The transfer of iliac periosteal flap with ascending branch of lateral femoral circumflex artery is an effective treatment for Legg-Calve-Perthes disease.

关 键 词：儿童股骨头缺血性坏死 旋股外侧动脉升支 骨膜瓣 显微外科手术 

分 类 号：R726.8[医药卫生—儿科]