吻合血管游离腓骨移植治疗股骨头缺血性坏死技术总结及手术器械改进
发布时间：2018-10-14 20:40
【摘要】：目的总结吻合血管游离腓骨移植(free vascularized fibular grafting,FVFG)治疗股骨头缺血性坏死(osteonecrosis of femoral head,ONFH)的临床技术,以及改进的手术器械在术中应用价值。方法2011年3月—2013年1月,采用改进的手术器械行FVFG治疗ONFH患者35例(47髋)。男24例(32髋),女11例(15髋);年龄22~43岁,平均34岁。单髋23例,双髋12例。病程5~9个月,平均7个月。ONFH类型:酒精性25髋,激素性12髋,创伤性3髋,特发性7髋。术前行X线片检查,根据国际骨循环协会(ARCO)分期标准:Ⅰ期3髋,Ⅱ期39髋,Ⅲ期5髋。术前髋关节Harris评分为(58.2±6.1)分。结果术中切取腓骨时间为15~35 min,平均25 min;手术时间90~200 min,平均130 min。术中出血量为150~500 m L,平均270 m L。术后切口均Ⅰ期愈合,无感染、下肢深静脉血栓形成等并发症发生。患者均获随访,随访时间12~42个月,平均28个月。末次随访时Harris评分为(87.3±5.7)分,较术前显著提高,比较差异有统计学意义(t=102.038,P=0.000)。X线片复查示,腓骨瓣位置良好,末次随访时股骨头坏死改善9髋,无进展36髋,进展2髋。结论采用FVFG治疗ONFH能有效改善患者髋关节功能,术中应用改进的手术器械能提高手术效率。
[Abstract]:Objective to summarize the clinical technique of vascularized fibula transplantation (free vascularized fibular grafting,FVFG) in the treatment of avascular necrosis of the femoral head (osteonecrosis of femoral head,ONFH) and the value of the improved surgical instruments in the operation. Methods from March 2011 to January 2013, 35 patients (47 hips) with ONFH were treated with FVFG. There were 24 males (32 hips) and 11 females (15 hips), aged 2243 years (mean 34 years). There were 23 cases with single hip and 12 cases with double hip. The course of disease ranged from 5 to 9 months (mean 7 months). ONFH type: alcoholic 25 hips, steroid 12 hips, traumatic 3 hips, idiopathic 7 hips. X-ray examination was performed before operation. According to the (ARCO) staging criteria of the International Bone Circulation Association, there were 3 hips in stage 鈪，
本文编号：2271580
[Abstract]:Objective to summarize the clinical technique of vascularized fibula transplantation (free vascularized fibular grafting,FVFG) in the treatment of avascular necrosis of the femoral head (osteonecrosis of femoral head,ONFH) and the value of the improved surgical instruments in the operation. Methods from March 2011 to January 2013, 35 patients (47 hips) with ONFH were treated with FVFG. There were 24 males (32 hips) and 11 females (15 hips), aged 2243 years (mean 34 years). There were 23 cases with single hip and 12 cases with double hip. The course of disease ranged from 5 to 9 months (mean 7 months). ONFH type: alcoholic 25 hips, steroid 12 hips, traumatic 3 hips, idiopathic 7 hips. X-ray examination was performed before operation. According to the (ARCO) staging criteria of the International Bone Circulation Association, there were 3 hips in stage 鈪，
本文编号：2271580
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