髂骨移植的显微外科解剖学研究

作者比较系统的观察了50具尸体(100侧)的髂骨及100侧干性髂骨,并做了血管的局部墨汁灌注和X线血管造影。对髂骨及其血管的位置、形态、口径、长度,以及考虑到手术显露中所需要的局部关系等,做了比较详细的研究。作者认为髂骨质疏松,可塑性大,血液供应丰富,充填确实,承重较好,且有适当的截取长度,故力理想的移植供区。按游离显微血管髂骨移植的要求:臀上动脉、旋髂深动脉、第三腰动脉作为髂骨移植的血管蒂的条件是很优越的;旋股外侧动脉、旋髂淺动脉适于作骨肌皮瓣复合组织的移植蒂;旋股外侧动脉适于作股骨头、颈骨内移植血管;第四腰动脉、髂腰动脉不适用于骨移植的血管蒂。

Study on the microsurgical anatomy for ilium transpiantation

The iliac bones of 50 cadavers (100 pieces)and 100 pieces of dry iliac bones were studied. Ink perfusion of local vessels and vasography were made. Detailed investigations have been made on the ilium and the position, morphology, calibre and length of its blood vessels. Consideration has been given to the local relationship necessary for surgical exposure, The author considers the ilium an ideal donor because of the fact that the ilium is loose in bone tissue, highly plastic,rich in blood supply,substantial in filling and strong in weight-hearing capacity, meanwhile it provides a desirable donor length. In regard to the requirements of ilium transplantation for free micro-blood vessels; the superior gluteal artery and circumflex iliac deep artery and third lumbar artery provide favourable conditions for vascular pedicles in ilium transplantation; the circumflex lateral artery and the circumflex iliac superficial artery will serve as appropriate pedicles for the transplantation of the compound tissue flap of bone, muscle and skin; the circumflex femoral lateral artery can be suitably used as the vessel for intraosteal transplantation of the head and neck of the femur: The fourth lumbar artery is, however, not suitable for use as vascular pedicles in bone transplantation.