自体缝匠肌蒂髂骨瓣治疗陈旧性股骨颈骨折疗效分析  

Clinical Efficacy of Autologous Sartorius Pedicle Iliac Flap in the Treatment of Old Femoral Neck Fractures

作　　者：马占伟 贾光辉[2] 楚利涛[3] MA Zhanwei;JIA Guanghui;CHU Litao(Department of Orthopedics,Shangcai Chongyang Hospital,Zhumadian,Henan 463800,China;Department of Foot and Ankle Surgery,Zhengzhou Orthopedic Hospital,Zhengzhou,Henan 452300,China;Department of Lower Limb Orthopedics,Zhengzhou Orthopedic Hospital,Zhengzhou,Henan 452300,China)

机构地区：[1]上蔡县重阳医院骨科,河南驻马店463800 [2]郑州市骨科医院足踝外科,河南郑州452300 [3]郑州市骨科医院下肢骨科,河南郑州452300

出　　处：《中国烧伤创疡杂志》2025年第1期72-74,共3页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的分析探讨陈旧性股骨颈骨折患者应用自体缝匠肌蒂髂骨瓣治疗的临床疗效。方法给予2019年3月至2022年3月上蔡县重阳医院收治的24例陈旧性股骨颈骨折患者于股骨近端锁定钢板内固定术后行自体缝匠肌蒂髂骨瓣移植治疗,观察患者骨折愈合情况及髋关节功能恢复情况。结果24例患者均顺利完成手术。术后,21例患者一期愈合;1例患者出现股骨头坏死,行人工髋关节置换治疗后髋关节功能恢复良好;2例患者骨折断端下方出现部分缺损,行二次植骨后愈合。术后12个月随访,11例患者患肢未见明显异常,Harris评分为95~100分,平均96.6分;11例患者患肢遗留不同程度短缩畸形,Harris评分为91~98分,平均94.7分;2例患者患肢遗留不同程度外旋畸形,Harris评分为88~92分,平均90.0分。结论给予陈旧性股骨颈骨折患者于股骨近端锁定钢板内固定术后行自体缝匠肌蒂髂骨瓣移植治疗,可有效填充骨折断端骨缺损,促进骨瓣成活及骨折愈合,疗效显著。Objective To study the clinical efficacy of autologous sartorius pedicle iliac flap in the treatment of old femoral neck fractures.Methods 24 patients with old femoral neck fractures admitted to Shangcai Chongyang Hospital from March 2019 to March 2022 were treated with autologous sartorius pedicle iliac flap transplantation after proximal femoral locking plate internal fixation.Fracture healing and hip joint function recovery of patients were observed.Results All the 24 patients successfully completed the operation.After the operation,21 patients had primary healing.Femoral head necrosis occurred in 1 patient,and the hip joint function recovered well after total hip arthroplasty.2 patients developed partial defects below the fracture ends and achieved healing after secondary bone grafting.At 12-month follow-upo,11 patients showed no significant abnormalities in the affected limb,with Harris scores ranging from 95 to 100 points,with an average of96.6 points.11 patients had different degrees of limb shortening deformity,with Harris scores ranging from 91 to 98 points,average 94.7 points.2 patients had different degrees of external rotation deformity of the affected limb,with Harris scores ranging from 88 to 92 points,average 90.0 points.Conclusion Autologous sartorius pedicle iliac flap transplantation after proximal femoral locking plate internal fixation in the treatment of patients with old femoral neck fractures can effectively fill the bone defect at the fracture end,promote the survival of bone flap and fracture healing,and the curative effect is significant.

关 键 词：缝匠肌蒂髂骨瓣 陈旧性骨折 股骨颈骨折 股骨头坏死 

分 类 号：R68[医药卫生—骨科学]