中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (44): 8283-8290.doi: 10.3969/j.issn.2095-4344.2012.44.022

• 骨与关节综述 bone and joint review • 上一篇    下一篇

带血管蒂大转子骨瓣联合植骨治疗股骨头坏死

朱绍灵1，2，曾意荣1   

  1. 1广州中医药大学第一附属医院三骨科， 广东省广州市 510405
    2四川省骨科医院，四川省成都市 610041)
  • 收稿日期:2012-02-20 修回日期:2012-03-19 出版日期:2012-10-28 发布日期:2012-10-28
  • 通讯作者: 曾意荣，博士，主任医师，广州中医药大学第一附属医院三骨科， 广东省广州市 510405
  • 作者简介:朱绍灵★，男，1986年生，重庆市人，汉族，2012年广州中医药大学第一附属医院毕业，硕士，现就职于四川省骨科医院，主要从事髋、膝关节疾病方面的研究。

Vascularized greater trochanter bone flap combined with bone grafting for the treatment of femoral head necrosis

Zhu Shao-ling1,2, Zeng Yi-rong1   

  1. 1The Third Department of Orthopedics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
    2Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan Province, China
  • Received:2012-02-20 Revised:2012-03-19 Online:2012-10-28 Published:2012-10-28
  • Contact: Zeng Yi-rong, Doctor, Chief physician, The Third Department of Orthopedics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China zeng6612@163.com
  • About author:Zhu Shao-ling★, Master, The Third Department of Orthopedics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan Province, China lincle914@qq.com

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摘要：

背景：由显微外科技术在股骨头坏死治疗的运用中发展而来的带血管蒂大转子骨瓣联合植骨为治疗中青年股骨头缺血性坏死的主要方法之一。
目的：通过回顾及分析对于大转子骨瓣移植治疗股骨头缺血性坏死的相关临床及基础研究，从不同层面对大转子骨瓣移植术的研究进行探讨。
方法：以“Osteonecrosis Femoral Head、greater trochanter bone flap”或“Osteonecrosis Femoral Head、 bone flap”或“Osteonecrosis Femoral Head、
finite element analysis”为检索词，检索pubmed数据库(1972年1月至2011年10月)；以“股骨头坏死、大转子骨瓣”为检索词，检索CNKI数据库(1979年1月至2011年10月)。选择以大转子骨瓣移植治疗股骨头坏死相关，同一领域文献则选择近期发表或发表在权威杂志文章。根据纳入标准共46篇文章进行综述。
结果与结论：关于目前较常用的病灶清除+带旋股外侧动脉横支大转子骨瓣联合打压植骨+游离髂骨瓣植骨治疗股骨头缺血性坏死报道甚少，此术式结合了皮质骨的生物力学优势，同时又有带旋股外侧动脉横支大转子骨瓣加松质骨粒提供良好的血供环境，能很好的解决血供与力学重建的平衡性，达到股骨头的生理重建。

关键词: 股骨头缺血性坏死, 大转子骨瓣, 骨移植, 显微外科技术, 组织学

Abstract:

BACKGROUND: The vascular pedicled greater trochanter bone flap combined with bone grafting developed from the application of microsurgical technique in the treatment of femoral head necrosis is one of the important methods for the treatment of young and middle aged osteonecrosis of the femoral head.
OBJECTIVE: To investigate the greater trochanter bone flap transplantation from different aspects through retrospectively analyzing the related clinical and basic research on greater trochanter bone flap transplantation for the treatment of osteonecrosis of the femoral head.
METHODS: The PubMed database (1972-01/2011-10) was searched with the key words of “osteonecrosis femoral head, greater trochanter bone flap” or “osteonecrosis femoral head, bone flap” or “osteonecrosis femoral head, finite element analysis” in English; the CNKI database (1979-01/2011-10) was also searched with the key words of “femoral head necrosis, greater trochanter bone flap” in Chinese. The articles that related to the greater trochanter bone flap transplantation for the treatment of femoral head necrosis were selected, and for the articles in the same filed, those published recently or in the authorized journals were preferred. Finally, a total of 46 articles were included for review according to the inclusion criteria.
RESULTS AND CONCLUSION: The reports on the commonly used focal cleaning+great trochanter bone flap with the pedicle of the transverse branch of lateral femoral circumflex artery combined with bone grafting+free iliac crest and bone grafting for the treatment of osteonecrosis of the femoral head are rare. This technique can keep the balance between the blood supply and mechanical reconstruction, and can achieve the physiological reconstruction of femoral head with the advantages, such as the biomechanical advantages of the cortical bone and the good blood supply conditions provided by great trochanter bone flap with the pedicle of transverse branch of lateral femoral circumflex artery plus cancellous.

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