吻合血管游离腓骨移植治疗股骨头坏死的临床疗效

目的评价吻合血管游离腓骨移植治疗股骨头坏死的临床疗效。方法收集2001年5月-2004年5月采用吻合血管游离腓骨移植治疗股骨头坏死50例（75髋），FicmⅠ期20髋，FicatⅡ期20髋，FicⅢ期20髋，FicmⅣ期15髋。结果本组优35髋（46．7％），良13髋（17．3％），可18髋（24．0％），差9髋（12．0％），优良率为54．0％；Ⅰ期优良率（100．0％）明显高于Ⅲ期（40．0％）和Ⅳ期（13．3％）（P〈0．05或0．01）；手术前后髋关节的疼痛、功能、关节活动度及X线表现总分有显著性差异（P〈0．05）；X线片显示，60髋（80．0％）的股骨头坏死有不同程度改善，13髋（17．3％）无明显变化，2髋（2．7％）恶化；Ⅰ期平均为96．5分，Ⅱ期平均为94．4分，Ⅲ期为86．0分，Ⅳ期为74．1分，均较术前明显提高（x^2=6．87，P〈0．05）。结论植入的带血管游离腓骨可增加股骨头部的血供和支撑作用，防止股骨头进一步塌陷。

The Curetive Effect of Vascularized Free Fibula Transplantation in Patients with Avascular Necrosis of Femoral Head

Objective evaluation of curetive effect of Vascularized free fibula transplantation in patients with avascular necrosis of femoral head. Methods 50 cases （75 hip）of avascular necrosis of femoral head,Ficat Ⅰ period of 20 hip,Ficat Ⅱ period of 20 hip,Ficat Ⅲ period of 20 hip, Ficat Ⅳ period of 15 hip. Results The excellent of hip 30（46.7% ）,fine of hip-13 （17.3%）, appeove of 18 hips （24.0%）,poor of 9 poor hip （ 12.0% ）, excellent rate of 48 hip （64.0%） ; Ⅰ period excellent rate （ 100.0% ） was significantly higher than the stage Ⅲ （40.0%） and Ⅲ （13.3% ）（P 〈 0.05 or 0.01 ）;the surgery before and after the pain, function and range of motion and X-ray total there were significant differences（P 〈 0.05 ）;X-ray display：60 hip （80.0%） of the femoral head necrosis have improved to varying degrees, 13 hips （17.3%） no signilicant changes in two hip（2.7 percent） worsened; Ⅰ period an average of 96.5%, Ⅱ period An average of 94.4%, Ⅲ period of 86.0%, Ⅳ period of 74.1%, compared with significantly improved （ x ^2= 6.87, P 〈 0.05 ）. Conclusion the implantation of vascular free fibula increase the femoral bead blood supply and supporting, the femoral head to prevent further collapse.