带蒂胫前骨膜瓣联合自体骨治疗距骨缺血坏死的疗效分析  

Treatment of Avascular Talar Necrosis by Transposition of Vascularized Anterior Tibial Periosteal Flap Plus Autogenous Bone Graft

作　　者：严佐发 苏云[1] 马彦明 邵全升 王洪勋[1] 孙强[1] Yan Zuofa;Su Yun;Ma Yanming(Affiliated Zhongshan Hospital of Dalian University,Dalian116001,China;Dalian University,Dalian116622,China;Graduate school of Dalian Medical University,Dalian116044,China)

机构地区：[1]大连大学附属中山医院,辽宁大连116001 [2]大连大学,辽宁大连116622 [3]大连医科大学研究生院,辽宁大连116044

出　　处：《实用骨科杂志》2018年第12期1082-1084,共3页Journal of Practical Orthopaedics

摘　　要：目的应用带蒂胫前骨膜瓣转位联合自体骨移植治疗距骨缺血坏死,并对其进行疗效分析。方法自2012年4月至2016年6月,应用带蒂胫前骨膜瓣转位联合自体骨移植治疗距骨缺血坏死24例,男14例,女10例;年龄42～77岁,平均57.2岁。按照改良的Ficat andArlet分期标准,Ⅱ期10例,Ⅲ期12例,Ⅳ期2例。术后对患者疗效按Kenwright的标准进行随访。结果随访时间24～96个月,平均36.2个月。评定结果优9例,良13例,可1例,差1例。患者临床症状完全或部分缓解,术后优良率为91.67%。结论带蒂胫前骨膜瓣转位联合自体骨移植治疗距骨缺血坏死取得了较为理想的临床效果,值得临床应用。Objective To evaluate the outcome of transposition of vascularized anterior tibial periosteal flap plus autogenous bone graft in the treatment of avascular talar necrosis.Methods From April 2012 to June 2016,24 patients,including 14 males and 10 females with an average age of 57.2 years old underwent surgery of transposition of vascularized anterior tibial periosteal flap plus autogenous bone graft.According to modified Ficat&Arlet classification system,10 cases were in stageⅡ,12 cases were in stageⅢ,and 2 cases were in stageⅣ.The patient was followed up by Kenwright's criteria.Results The follow-up period was 24 to 96 months,with an average of 36.2 months.According to Kenwright criteria,9 cases were excellent,13 cases were good,1 case was fair,and 1 case was poor.The clinical symptoms were completely or partially relieved.The excellent and good rate was 91.67%.Conclusion Vascularized anterior tibial periosteal flap plus autogenous bone graft for the treatment of talar avascular necrosis has achieved satisfactory clinical results and is worthy of clinical application.

关 键 词：距骨 骨坏死 骨膜瓣 自体骨移植 

分 类 号：R622[医药卫生—整形外科]