带旋髂深血管蒂髂骨植骨治疗股骨颈骨折和股骨大粗隆病损

目的 分析和总结带旋髂深血管蒂骼骨植骨治疗股骨颈骨折和股骨大粗隆病损的经验和体会。方法 采用带旋髂深血管蒂骼骨植骨治疗陈旧性股骨颈骨折不愈合、股骨颈骨囊肿、股骨大粗隆骨巨细胞瘤共27例。术中先解剖出旋髂深血管，于股骨颈前外侧开凿骨槽／清除肿瘤病变组织，取与骨槽／瘤位相应口径的带旋髂深血管蒂的髂骨块，嵌入骨槽／瘤床内，空隙部位用髂骨碎条块充填。结果 平均随访3年8个月（11个月－7年），疗效满意。X线复查见股骨颈骨折愈合良好，肿瘤辞除后的骨缺损均修复。结论 带旋髂深血管蒂的髂骨植骨治疗股骨颈骨折和股骨大粗隆病损是一种可选择的行之有效的方法。

Plantation of Iliac Flap Pedicled with Deep Circumflexes Iliac Vessels for Focus in Greater Trochanter and Neck of Femur

Objective To analyse and make a conclusion on the plantation of iliac flap pedicled with deep circumflexus iliac vessels for focus in the greater trochanter and neck of the femur. Methods There were 27 cases treated by using the iliac flap with the vessel pedicle. These cases included cysts of the femoral neck, giant cell neoplasm of the greater trochanter, non healing of the femeral neck fracture, etc. After finding the deep circumflexes vessels, a furrow was made on the neck of the femur and the focus in which was cleaned, a piece of iliac flap pedicled with deep circumflexes vessels according to the size and shape of the focus was planted. The gap was filled up with small chips of the ilium. Results The patients were followed for 11 months to 7 years (averaged 3 years and 8 months), the therapeutic effect was satisfying. X rays exam after the operation indicated that fracture of the neck of the femur healed satisfactorily, and that the defects from cleaning of the tumors had disappeared. Conclusion The plantation of iliac flap pedicled with deep circumflexes iliac vessels for the focus in the greater trochanter and neck of the femur is an available and satisfying method.