血管化的自体骨移植术在骨科临床上应用(附208例报道)

本文报道我院骨科自1978～1991年采用带血管蒂的游离骨移植术,治疗各种原因的骨缺损、骨坏死和骨不连接208例、210次手术。其中带血管蒂的骨瓣转移术102例、103次手术。吻合血管的移植术106例、107次手术。供体有含旋髂深血管,臀上血管深上支,旋股外血管、第3腰动脉的髂骨瓣含肺动静脉的腓骨,含第1掌背血管的掌骨瓣以及含旋肩胛血管的肩胛骨复合瓣。治疗股骨头缺血性死19例;各种骨缺损、骨不连119例,术后随访时间最长达9年,最短为6个月,被移植骨瓣在受区达到性愈合的206次,占210次手术的98.1％。

CLINIC APPLICATION OF TRANSPLANTATION FREE VASCULARIZED AUTOGRAFT OF BONE (A report of 208 cases)

In this paper we present our clinical experience from 1978 to 1991 with use of free vascular iliac bone vessels ,profound superior branches of superior gluteal vessels,third lumbar vessels, vas-cularization of the fibular,first metacarpal of dorsum,superior branches circumflex femoral lateral of bone and scapular bone and skin of circumflex scapular vessels. The contribution to the treatment of avascular necrosis of the femoral head in children and adult,non-union fractures,bony defects in the extremities due to trauma or infection of bones,congenital pseudoarthrosis and massive bone defects resulting from bone tumor resection was evaluated in 208 cases. Of the 102 cases undergoing transplantation of vascular pedicle iliac and first metacarpal bone grafts,the microvas-cular anastomosis free transfer of bone grafts was ordered for the 106 cases. The outcome turned out to be satisfactory.