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find Keyword "骨瓣" 63 results
  • TREATMENT OF AVASCULAR NECROSIS OF TALUS WITH VASCULARIZED BONE GRAFT

    In order to study the curative effect of vascularized bone graft in the treatment of avascular necrosis of talus, 24 patients were treated with vascularized bone grafts, in which 9 cases had received 1st cuneiform bone graft with a malleolaris anteriomedialis, 4 cases with the 1st cuneiform bone graft with the medial tarsal artery and 11 cases with vascularized cuboid bone graft with the lateral tarsal artery. All of the patients were followed up for 3-5.5 years. The clinical observation and X-ray examination showed that function of the ankle joint was completely or almost normal in 16 cases, and the bone repair was excellent. There was slight pain in the ankle joint in 4 cases. The efficiency rate of the treatment was 83.3%. It could be concluded that vascularized bone graft might be an effective method in the treatment of avascular necrosis of talus.

    Release date:2016-09-01 11:07 Export PDF Favorites Scan
  • 带旋髂深血管蒂髂骨及髂骨膜瓣移位治疗中青年股骨颈骨折

    目的 总结带旋髂深血管蒂髂骨及髂骨膜瓣移位治疗中青年股骨颈骨折的手术方法及临床疗效。 方法 2003 年4 月- 2007 年3 月,收治22 例中青年股骨颈骨折患者。男12 例,女10 例;年龄25 ~ 53 岁,平均42 岁。均为闭合性骨折。致伤原因:交通事故伤18 例,高处坠落伤4 例。受伤至手术时间5 h ~ 43 d。新鲜骨折20 例,陈旧性骨折2 例。骨折部位分型:头下型10 例,经颈型12 例。骨折Garden 分型:Ⅲ型6 例,Ⅳ型16 例。术前Harris 髋关节功能评分(22.80 ± 8.75)分。采用带旋髂深血管蒂髂骨及髂骨膜瓣移位加空心加压螺钉治疗。 结果 术后1 例供区伤口伴液化渗出,经换药治愈;其余切口均Ⅰ期愈合。术后患者均获随访,随访时间20 ~ 60 个月,平均42 个月。21 例股骨颈骨折愈合,愈合时间3 ~ 6 个月,平均3.5 个月;1 例骨折不愈合并股骨头缺血性坏死,于术后6 个月行人工全髋关节置换术。术后14 个月Harris 评分为(86.40 ± 7.95)分,与术前比较差异有统计学意义(P lt; 0.05)。 结论 带旋髂深血管蒂髂骨及髂骨膜瓣治疗中青年股骨颈骨折可改善骨折端血运,促进骨折愈合,减少股骨头坏死的发生。

    Release date:2016-09-01 09:06 Export PDF Favorites Scan
  • TREATING AVASCULAR NECROSIS OF FEMORAL HEAD IN YOUNG ADULT BY GRAFTING SARTORIUSMUSCLE ILIAC BONE FLAP

    Objective To explore an improved method of treating avascular necrosis of the femoral head in young adults by grafting the sartorius muscle iliac bone flap. Methods From September 1994 to August 2003, 68 patients (57 males, 11 females; age, 16-58 years) underwent of the transplant the sartorius muscle oliac bone flap into the femoral head after decompression of the femoral head medullary core and removal of the dead bone and the fibrous tissue in the femoral head. The transplantation was performed on 31 patients left-unilaterally, on 37 patients rightunilaterally, and on 7 patients bilaterally. The pathological causeswere as follows: alcoholism in 52 patients, prolonged use of hormones in 6, traumain the hip in 6, and undetermined cause in 4. Their illness course ranged from 8 months to 4 years. According the Ficat staging, 10 patients belonged to Stage I (11 sides), 27 patients to Stage Ⅱ (31 sides), and31 patients to Stage Ⅲ (33 sides). Results The follow-up of the 68 patientsfor 2.5-11 years averaged 5.2 years revealed that based on the Harris evaluation for the hip function, 23 patients had an excellent result, 33 had a good result, 10 had a fair result, and 2 had a poor result. The excellent and good resultsaccounted for 82.3%. There was no recurrence after operation. Conclusion Thismethod has the following advantages: the lesion focus can be eradicated; enoughdecompression can be achieved, and the blood circulation for the femoral head can be rebuilt. The grafting of the sartorius muscle iliac bone flap can bring the osteogenesis components to the femoral head, promoting the reconstruction of the bones. This method is suitable and effective for the patients with avascular necrosis of the femoral head (Ficat Grades Ⅰ, Ⅱ and Ⅲ) in young adults. 

    Release date:2016-09-01 09:23 Export PDF Favorites Scan
  • TRANSFERRING OF THE PEDICLED SECOND METATARSAL BASE FOR REPAIRING BONE DEFECT OFLATERAL MALLEOLUS

    Objective To study the method and effect of transferring the pedicled second metatarsal base for repairing bone defect of lateral malleolus. Methods Thirty lower limb specimens were anatomized to observe the morphology, structure and blood supply of the second metatarsal bone . Then transferring of thepedicled second metatarsal base was designed and used in 6 patients clinically.All cases were male, aged from 24 to 48 years old, and the area of bone defect was 3-4 cm. Results Followed up for 3-11 months, all patients healed primarily both in donor and recipient sites. There were excellent results in 4 cases and good results in 2 cases . The morphology and function of the malleoli were satisfactory. Conclusion Transferring of the pedicled second metatarsal base for repairing bone defect of lateral malleolus is an effective and reliable operative method.

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  • TREATMENT OF NONUNION OF SCAPHOID BONE BY TRANSFER OF RADIAL PERIOSTEAL BONE FLAP PEDICLED WITH RECURRENT BRANCH OF RADIAL ARTERY

    OBJECTIVE: To introduce the operation method of treatment of nonunion of scaphoid bone by transfer of pedicled radial periosteal bone flap. METHODS: From Match 1986, 26 cases with old nonunion of scaphoid bone were treated by transfer of radial periosteal bone flap pedicled with recurrent branch of radial artery, the size of bone flap was 1.0 cm x 0.4 cm x 0.5 cm. RESULTS: All patients with old nonunion of scaphoid bone were healed by first intention, bone union was occurred after 2 to 3 months of operation, and wrist joint almost recovered normal function. CONCLUSION: It is an effective operation method to treat nonunion of scaphoid bone.

    Release date:2016-09-01 10:27 Export PDF Favorites Scan
  • TRANSPOSITION OF MUSCULAR SKELETAL FLAP PEDICLED WITH STRAIGHT HEAD OF RECTUS FEMORIS FOR TREATMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD

    OBJECTIVE: To investigate the clinical results of transposition of muscular skeletal flap pedicled with straight head of rectus femoris for treatment of avascular necrosis of adult femoral head. METHODS: Eight patients with avascular necrosis of femoral head were adopted in this study. There were 6 males and 2 females, the ages were ranged from 24 to 56 years. According to the criteria of Ficat, there were 5 cases in stage II and 3 cases in stage III. The Smith-Peterson incision was used to expose the capsule of the hip. After complete curettage of the necrotic bone from the femoral head, the muscular skeletal flap pedicled with straight head of rectus femoris was resected and transposited into femoral head. Finally, conventional decompression of head was performed. RESULTS: All the cases were followed up for 1 to 3 years. There were excellent results in 5 cases, good in 2 cases and moderate in 1 case. The rate of excellent and good results were 87.5%. CONCLUSION: Comparing with other pedicled bony flaps, the muscular skeletal flap pedicled with straight head of rectus femoris is characterized by its convenience and efficacy. It is suitable for the treatment of avascular necrosis of femoral head in stage II or III, but the contour of the femoral head should be nearly normal.

    Release date:2016-09-01 10:26 Export PDF Favorites Scan
  • THE CLINICAL APPLICATION OF ILIAC BONE GRAFT WITH ASCENDING BRANCH OF LATERAL CIRCUMFLEX FEMORAL VESSEL

    Since 1984, the authors have used the iliac bone graft with ascending branch of lateral circomflex femoral vessel for treatment of bone defect, nonunion, and avascular necrosis of femoral head in 88 cases. Seventy-two patients were followed from one to six years. Seventy cases were successful with 2 failure. The applied anatomy and clinical application of the iliac bone graft, and the operative principles were discused in this article.

    Release date:2016-09-01 11:39 Export PDF Favorites Scan
  • 以跗外侧血管为蒂的骰骨瓣转位术

    以跗外侧血管为蒂的骰骨瓣具有血管位置恒定、表浅,易于解剖的特点。本骨瓣主要用于踝关节,距下关节融合和距骨颈骨折开放复位需植骨者,也适于其它邻近骨与关节病损部植骨。

    Release date:2016-09-01 11:38 Export PDF Favorites Scan
  • 带肌蒂髂骨瓣植骨融合治疗腰椎滑脱症

    报道5例腰椎Ⅰ~Ⅱ°滑脱,伴有腰痛患者,釆用带腰髂肋肌蒂的髂骨瓣移位作脊柱融合手术。经随访,全部达到骨性融合,腰痛症状解除。介绍了手术方法。

    Release date:2016-09-01 11:38 Export PDF Favorites Scan
  • TREATMENT OF ADULT AVASCULAR NECROSIS OF FEMORAL HEAD BY TRANSPLANTING ILIAC BONE FLAP WITH DEEP ILIAC CIRCUMFLEX VESSELS AND CANCELLOUS BONE

    Objective To investigate the effectiveness of transplanting iliac bone flap with deep iliac circumflex vessels and cancellous bone for the treatment of adult avascular necrosis of the femoral head (ANFH). Methods A retrospective analysis was made on the clinical data of 685 patients (803 hips) with ANFH, who underwent iliac bone flap transplantation with deep iliac circumflex vessels and cancellous bone between March 2002 and January 2010. There were 489 males (580 hips) and 196 females (223 hips) with a mean age of 40.4 years (range, 18-63 years), including 567 unilateral cases (303 left hips and 264 right hips) and 118 bilateral cases. The causes of ANFH included alcohol-induced in 223 cases, steroid-induced in 179 cases, alcohol + steroid-induced in 21 cases, traumatic in 136 cases, acetabular dysplasia in 8 cases, bone cyst in 5 cases, septic arthritis in 2 cases, joint tuberculosis in 3 cases, rheumatoid arthritis in 5 cases, and idiopathic in 103 cases. According to Steinberg staging, 211 hips were rated as stage II, 513 hips as stage III, and 79 hips as stage IV. The preoperative Harris hip score was 60.30 ± 7.02. Results Fat necrosis occurred in 2 cases after operation, primary healing of incision was obtained in the other cases; delayed infection, lower extremity deep vein thrombosis, and pulmonary embolism occurred in 2 cases, respectively. All patients were followed up 36-60 months (mean, 49 months). Harris hip score at last follow-up (83.50 ± 7.31) was significantly higher than that at preoperation (t= — 2 266.980, P=0.000), and the scores were significantly higher than those at preoperation in different stages (P lt; 0.05). The results were excellent in 523 hips, good in 185 hips, fair in 65 hips, and poor in 30 hips, and the excellent and good rate was 88.2%. X-ray examination showed bone fusion of transplanted bone flap and bone graft with an average of 4.2 months (range, 3-6 months); according to Steinberg staging, imaging stable rate was 78.3% (629/803) at last follow-up. Conclusion Iliac bone flap transplantion with deep iliac circumflex vessels and cancellous bone has the advantages of complete decompression of the femoral head, exact flap blood supply, improved blood supply of the femoral head, new support for the femoral head, and participation of osteoinductive effect for the treatment of adult ANFH, so it is an effective treatment for the retention of the femoral head.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
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