带旋股外侧血管升支的臀中肌支大转子骨瓣转移治疗股骨头缺血性坏死

目的 为治疗股骨头缺血性坏死提供一种新的显微外科治疗方法。方法 在解剖学研究的基础上，设计旋股外侧血管升支的臀中肌支大转子骨瓣转移治疗股骨头缺血性坏死。结果 临床应用17例，经过1．5～3．5年，平均206年随诊，疗效满意。结论 该方法损伤小，简便易行，可以为股骨头提供丰富的血运及诱导成骨因素，是一种治疗股骨头缺血性坏死的有效方法。     

带旋股外侧血管升支的臀中肌支大转子骨瓣转移治疗股骨头缺血性坏死

目的　为治疗股骨头缺血性坏死提供一种新的显微外科治疗方法。方法　在解剖学研究的基础上 ,设计旋股外侧血管升支的臀中肌支大转子骨瓣转移治疗股骨头缺血性坏死。结果　临床应用 1 7例 ,经过 1 5～ 3 5年 ,平均 2 6年随诊 ,疗效满意。结论　该方法损伤小 ,简便易行 ,可以为股骨头提供丰富的血运及诱导成骨因素 ,是一种治疗股骨头缺血性坏死的有效方法。     

不负重高压氧治疗Perthes病

目的评价不负重高压氧治疗Perthes病的疗效。方法以不负重高压氧（250kPa）连续面罩吸氧治疗35例Perthes病。男21例，女14例，平均6．7岁。其中CatterallⅡ期12例，Ⅲ期18例，Ⅳ期5例。平均治疗169次。随访平均6．4a。结果2个月后临床症状消失。6个月后X线片显示股骨头密度与正常侧无明显差异。1a后股骨头发育良好，髋关节间隙正常。Mckay评定标准，优22例，良8例，可3例，差2例，优良率达85．7％。股骨头的骨骺高度与骺板宽度比值与治疗前有显著性差异（P〈0．05）。结论不负重高压氧治疗Perthes病简单方便、无创伤、无副作用、疗效满意，是一种良好的治疗方法。     

臂下血管吻合支大转子骨瓣转位重建股骨头：介绍一种治疗…

在解剖学研究的基础上，作者设计了以臂下血管吻合支为蒂的大转子骨瓣转位重建股骨头，为治疗中、青年人晚期股骨头坏死提供一种新的疗法。经临床应用１８例，取得良好疗效。     

股骨头表面重建术治疗FicatⅣ期12岁以上Perthes病

目的探讨股骨头表面重建术治疗FicatⅣ期12岁以上Perthes病的手术方法和效果。方法对5例FicatⅣ期12岁以上Perthes病患儿行股骨头表面重建术。结果随访12～36个月,所有患儿行走无疼痛,生活自理,可上学。按修订后的’82北京髋关节功能评定标准,4例为优,1例为良。结论股骨头表面重建术治疗FicatⅣ期12岁以上Perthes病,短时间内可恢复正常行走能力,满足了患儿日常生活学习的需要,为成年后的人工关节置换提供了一个良好的过渡。     

臀下血管吻合支大转子骨瓣转位重建股骨头──介绍一种治疗成人晚期股骨头坏死的新手术

在解剖学研究的基础上，作者设计了以臀下血管吻合支为蒂的大转子骨瓣转位重建股骨头，为治疗中、青年人晚期股骨头坏死提供一种新的疗法。经临床应用１８例，取得良好疗效。     

股骨头缺血性坏死的治疗

目的：探讨治疗股骨头坏死的疗效。方法：回顾复习了1982年6月至1997年5月采用滑膜切除、血管束植入为主，结合病灶刮除、钻孔、旋转截骨钢板固定、臼盖成形、髋人字石膏外固定等综合治疗股骨头坏死共224髋，其中Perthes病166髋，成人股骨头坏死158髋。结果:随访10个月以上，并资料完整172例，在14岁以下166髋中优占94.7%，良3.3%。成年人组占81%，良5.2%。结论：综合治疗是一种股头缺血性坏死的有效方法。     

Salter骨盆截骨治疗Perthes病

儿童股骨头缺血性坏死(Legg-Calve-Perthes病,简称Perthes病)是儿童比较常见的髋关节疾病,由于病因尚不清楚,治疗方法各家不一.我科自1992年8月至1999年10月,采用Salter骨盆截骨术,配合胫骨结节牵引和CPM机治疗Perthes病12例,经随诊观察,疗效较满意.     

带旋股外侧血管横支大粗隆骨瓣转移在股骨头重建中的应用

目的 探讨带旋股外侧血管横支大粗隆骨瓣转移在股骨头重建中的临床应用及疗效。方法 选择Ficat分期中Ⅲ-Ⅳ期成人股骨头缺血坏死病例15例，施行病灶清除，采用带旋股外侧血管横支大粗隆骨瓣转移。重建股骨头。结果 临床应用15例，其中12例获得随访，平均2.9年，髋关节功能恢复满意，优良率达75.5%。结论 股骨头缺血坏死病灶清除订后的骨缺损，采用带旋股外侧血管横支大粗隆骨瓣转移。重建股骨头，恢复髋关节功能，是一种可行的手术方法。     

旋股外侧血管横支大转子骨瓣和升支髂骨膜转移再造股骨头

从1992年4月开始,应用旋股外侧血管横支的大转子骨瓣和升支的髂骨膜转移的方法,对股骨头无菌性坏死严重者,进行股骨头再造。临床应用17例,经2年以上随访观察,体会到该方法有解剖学的基础,手术在一个切口内完成,简便易行,再造股骨头和原头形状相近的优点。     

Apophysiolysis of the anterior inferior iliac spine

Summary Four cases of avulsion of the anterior inferior iliac spine were presented. Three of them affected boys of about 15 years (2 after a strain without local trauma—1 after local trauma). The fourth was discovered by chance on the X-rays of a man.Histological examination was made of 2 cases. A recent one showed the remodelling of a fracture of the apophysary growth cartilage. An older one showed aspecific bone remodelling.The incidence, clinical and radiological data, pathology and pathogenesis of such apophysiolysis is discussed.

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Apophyseolysis der Spina iliaca anterior inferiorEine histologische, klinische und radiologische Untersuchung

Zusammenfassung 1. 4 Fälle von Abriß der Spina iliaca anterior inferior werden vorgestellt. 3 von diesen betrafen Jungen im Alter von 15 Jahren (2 nach einer Überlastung ohne lokales Trauma — 1 nach einem lokalen Trauma). Der vierte wurde zufällig bei Röntgenuntersuchungen eines Mannes festgestellt.2. Die histologische Untersuchung wurde in 2 Fällen durchgeführt. Ein kurzfristig zurückliegender Abriß zeigte den Umbau einer Fraktur des apophysären Wachstumsknorpels. Ein älterer Abriß zeigte unspezifische Knochenneubildung.3. Die Häufigkeit, klinische und radiologische Charakteristika, Pathologie und Pathogenese dieser Apophyseolysen werden besprochen.

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We would like to express our thanks to Mrs. Dr. J. Roddolo, Dr. R. Glatt and Dr. K. Ulman (Geneva), Dr. H. de Roten (Sion) for having kindly provided us with the clinical and radiological informations.     

Fracture of the anterior superior iliac spine following anterior cervical fusion using iliac crest. Case report.

A case is presented in which fracture of the right anterior superior iliac spine occurred 2 weeks after the right iliac crest had been used as the donor site for a two-level anterior disectomy and fusion.     

Ambulatory in-office anterior iliac crest bone harvesting.

OBJECTIVE: A prospective study was performed to evaluate the harvesting of autologous bone within the private practice environment, using either a power-driven trephine or corticocancellous block harvesting, and to assess the clinical safety, postoperative morbidity, and patient satisfaction associated with this application. STUDY DESIGN: Thirty-nine patients requiring 40 bone harvests from the anterior iliac crest for maxillofacial reconstruction were included for study. The ages ranged from 16 to 73 years (mean 48.4 years). All surgeries were performed by a single surgeon. Patients were recovered and discharged home directly from the office. RESULTS: Forty iliac crest harvests were performed in the private practice venue from 2001 to 2004, 23 by motorized trephine and 17 by open corticocancellous block harvest. No peri-operative complications were encountered. Postoperative questionnaires were returned by 32 patients. Thirty patients reported that they would undergo hip surgery in an ambulatory environment again if required. CONCLUSION: Harvesting of bone from the anterior iliac crest is a safe and predictable surgical procedure for the private oral and maxillofacial surgical practice setting in selected cases, resulting in a low complication rate. Patient acceptance of this surgery in the private practice venue is high.     

脊柱前路手术髂前嵴取骨并发症相关分析

目的:探讨脊柱前路手术髂前嵴取骨的并发症发生情况。方法:回顾性分析2001年1月-2005年9月取髂骨行脊柱植骨融合术的154例患者,取骨部位均为髂前嵴,统计供骨区并发症,分析其相关因素。结果:术后随访时间均超过1年。28例(18.2%)患者发生不同程度的并发症,其中14例(9.1%)出现轻度并发症,12例(7.8%)出现中度并发症,2例(1.3%)出现重度并发症。127例(82.5%)患者接受了问卷调查,其中17例(13.4%)患者诉取骨处疼痛,疼痛自我感觉评分为1-6分(平均2分),其中3例(2.4%)患者需服用非甾体类抗炎药以减轻疼痛;7例(5.5%)患者诉取骨处有麻木感;无患者诉取骨处的疼痛及麻木感影响其日常活动;122例(96.1%)患者对供骨区切口外观满意。结论:髂前嵴取骨并发症中供骨区疼痛及麻木发生率较高,尤其是疼痛,应引起足够的重视。     

Cancellous bone in the anterior part of the iliac crest

Summary Calcified tissue in the iliac crest and the adjoining ala of the ilium was investigated by scanning electron micrographs of thick, polished sections from which the marrow had been removed. Some quantitative properties of the trabeculae and of the marrow spaces were obtained from measurements on the images of the polished surfaces. Most of the cortex of the crest was porous, about 25% void, of varying thickness, intruding into the cancellous space in some regions. A structure containing about 35% by volume of bone was found at and near the anterior superior spine. Compact bone of normal appearance began as thin medial and proximal sheets below the crest, and thickened until at 20–30 mm it was substantial. The cancellous bone contained by these structures was varied. Two main zones were distinguished, whose junction ran from just below the anterior superior spine to the lower portion of the iliac fossa. In the lateral zone, adjacent to the crest, there were arch-like structures, commencing from the medial and proximal walls, and meeting, or even crossing, near the centre. The medial zone was distinguished by large marrow cavities and strongly orientated trabeculae. The relative volume of bone was similar in the two zones, falling from a maximum of 15–20% to about 5% in the regions of the anterior inferior spine and the iliac fossa. The average width of the trabeculae was significantly greater in the medial than in the lateral zone (W _b (m)0.16 mm, W_b(l)0.12 mm). Inclusions of very heavily constructed trabeculae, having average widths of about 0.35 mm, were found in both zones.     

可吸收螺钉治疗髂前上棘骨折

我科1995年以来采用可吸收螺钉治疗髂前上棘骨折30例,临床上取得满意效果,现报道如下.     

Clinical results with anterior diagonal iliac osteotomy in bladder exstrophy

PURPOSE: We report our clinical experience with anterior diagonal iliac osteotomy in 10 patients who underwent surgery for bladder exstrophy. Technique and long-term results are discussed. MATERIALS AND METHODS: A total of 10 boys 1 month to 9 years old with bladder exstrophy underwent this procedure during a 2-year period. RESULTS: None of the patients had bladder closure dehiscence or prolapse after the operation. There were neither infectious complications nor injury to the vessels or nerves in any case. Blood loss was minimal for anterior diagonal iliac osteotomy. The only significant complication in our series was the polypropylene erosion of the urethra, necessitating endoscopic removal in 1 patient 1 month postoperatively. All patients had wide diastasis of the pubis preoperatively (average pubic distance 53.3 cm., average pubic ratio 0.9). At surgery suturing the symphysis after bilateral osteotomy resulted in a satisfactory symphyseal approximation and tension-free closure of the abdominal wall was easily achieved in all cases. Radiological studies at a mean followup of 34.6 months (range 14.8 to 49.5) revealed significant recurrent diastasis of the pubic bones in all but 1 patient in whom bone grafts were applied between the iliac fragments. Mean interpubic distance was 42 cm. and mean pubic ratio was 0.6 at long-term followup. CONCLUSIONS: Diagonal osteotomy may correct the principal bony deformity in exstrophy and enables initial symphyseal approximation. Pubic diastasis may recur, probably due to opening forces generated by soft tissue elements of the pelvis.