带阔筋膜张肌蒂胫骨骨膜移植术治疗骨关节炎症骨不连

目的　探讨带阔筋膜张肌蒂胫骨骨膜移植术修复骨关节软骨缺损及骨不连。方法　对 4例髋关节结核行病灶清除而有软骨缺损 ;1例股骨骨髓炎行病灶清除 ,开窗 ,减压 ,肌瓣填塞 ;1例股骨骨不连 ,采用带阔筋膜张肌蒂胫骨骨膜 游离骨膜移植。结果　髋关节功能不同程度恢复 ,无融合或强直 ,恢复正常工作 ,日常生活可自理 ,疼痛完全缓解。带阔筋膜张肌蒂胫骨骨膜移植血运建立快 ,成软骨作用强 ,修复骨缺损并具有抗炎及关节外成骨作用。结论　带阔筋膜张肌蒂胫骨骨膜移植术对关节软骨缺损、骨不连、骨髓炎均具有成软骨、成骨及增强抗感染的作用 ,修复重建关节功能效果好 ,在髋关节软骨缺损重建头臼功能中可作为首选术式。

TIBIAL PERIOSTEUM TRANSPLANTATION WITH TENSOR FASCIAE LATAE MUSCLE IN OSTEOARTHRITIS AND BONE NONUNION

Objective To investigate the reparation of articular cartilage defect and nonunion by tibial periosteal transplantation with tensor fasciae latae muscle. Methods 4 cases with coxa Tb received focal cleaning and cartilage defect,1 case with osteomyelitis of femur received focal cleaning and fenestration and decompressing and muscle flap tamping,1 case with femur nonunion received tibial periosteal transplantation plus free periosteal graft. Results The coxa function recovered at various levels without fusion or rigidity.All the patients work and live in normal way with pain relieved completely.Blood circulation after tibial periosteal transplantation with tension fasciae latae muscle established quickly with strong chondroplasty function. Conclusion Tibial periosteal transplantation with tensor fasciae latae muscle has chondroplasty and anti-infection function to articular cartilage and bone nonunion and osteomyelitis.The recovery function is effective.It may be the first choice of operation to repair the femoris caput and acetabulum function in treatment of coxa cartilage defect.