利用带蒂髌骨移植修复重建股骨髁

目的 利用带蒂髌骨重建股骨内髁、外髁适用于良性肿瘤或低度恶性骨肿瘤行瘤段切除后造成的或外伤、感染破坏引起的股骨髁缺损，使其恢复正常解剖结构与功能。方法根据股骨髁缺损的部位分离股内侧肌下段及其相连的髌骨，保护通向肌肉和髌骨的血管。将髌骨关节面修整后重建股骨髁并妥善固定，一期修复髌韧带。结果 自1992年7月至2001年10月应用带肌蒂髌骨移植修复股骨内外髁缺损16例患，经随访观察关节伸屈度大于90度、功能恢复良好。结论 带肌蒂髌骨移植修复了股骨髁的缺损，基本恢复股骨髁外形。因采用带血供的自体活骨，故骨愈合较快，用髌前腱膜代替股骨髁关节面，有利于膝关节面及关节功能的恢复。

Transfer of the patellar with vascular and muscular pedicle for the reconstruction of femoral condyle

Objective To reconstruct the femoral condyle by transfer of the patellar with vascular and muscular pedicle. The method is appropriate for the patients with bone defect after resection of low - grade malignant tumor or the defect caused by infection or trauma, thus restore the knee joint anatomically and functionally. Methods According to site of defect on the femoral condyle, the lower part uf musculus vastus medialis or vastus lateralis and the connected patellar were isolated, caring to preserve the blood supply to the muscles and patellar. The femoral condyle was recon- structed after the articular surface of patellar was trimmed and the patellar was well fixed in place. The patellar tendon was reconstructed in primary stage. Results Since July 1992 to October 2001 , 16 cases of patients were treated with re- construction for the medial or lateral femoral condyle by this method. The follow-up studies showed that the function of knee joint recovered well. The mean range of motion of knee was more than 90 degrees. Conclusion Reconstruction of the femoral condyle by transfer of the patellar with vascular and muscular pedicle can generally restore the figuration of the femoral condyle. Because it used living bone with blood supply, the bone healing was more rapidly. The articular surface of the femoral condyle was well substituted by pre - patellar aponeurosis. It was beneficial to restoration of knee function.