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.