Since 1984, the authors have used the iliac bone graft with ascending branch of lateral circomflex femoral vessel for treatment of bone defect, nonunion, and avascular necrosis of femoral head in 88 cases. Seventy-two patients were followed from one to six years. Seventy cases were successful with 2 failure. The applied anatomy and clinical application of the iliac bone graft, and the operative principles were discused in this article.
目的 目前对青壮年有移位新鲜股骨颈骨折患者的治疗仍存在许多争议，被认为尚未完全解决难题之一，股骨颈骨折内固定术后常导致骨折不愈合股骨头缺血性坏死。 方法 2003年1月-2008年6月，收治青壮年新鲜移位股骨颈骨折患者12例，年龄17~55岁，平均36.3 岁。所有患者在受伤后1周内采用牵引下闭合复位空心钉内固定加股方肌骨瓣移植术治疗。术后随访1~5年，平均3.5年。 结果 12例患者均达骨性愈合，随访期内未出现股骨头缺血性坏死；术后采用Harris 髋关节评分标准进行评估，获优良10例，一般1例，差1例。 结论 青壮年新鲜有移位股骨颈骨折患者，采用牵引下闭合复位空心钉内固定加股方肌骨瓣转移术治疗效果良好，均能达到骨折愈合，且无股骨头缺血性坏死发生。
Objective To study the method and effect of transferring the pedicled second metatarsal base for repairing bone defect of lateral malleolus. Methods Thirty lower limb specimens were anatomized to observe the morphology, structure and blood supply of the second metatarsal bone . Then transferring of thepedicled second metatarsal base was designed and used in 6 patients clinically.All cases were male, aged from 24 to 48 years old, and the area of bone defect was 3-4 cm. Results Followed up for 3-11 months, all patients healed primarily both in donor and recipient sites. There were excellent results in 4 cases and good results in 2 cases . The morphology and function of the malleoli were satisfactory. Conclusion Transferring of the pedicled second metatarsal base for repairing bone defect of lateral malleolus is an effective and reliable operative method.
OBJECTIVE To investigate a new operative method for repairing nonunion and defect of tibia. METHODS First, observe the relation between the joint branches of descending genicular artery and the saphenous branch of descending genicular artery in 10 cadevers. Then the medial femoral condylar bone flap pedicled with the saphenous vessels was prepared in 4 cadavers for simulated purpose. Clinically, two patients with tibial nonunion were treated by transplantation of this pedicled bone flap. RESULTS: In the 4 simulated operations, the ink which was injected into the femoral artery could be released from the joint branches. And in the clinical operation, the area of the pedicled bone flaps were 5.0 cm x 2.0 cm x 1.5 cm and 4.5 cm x 1.5 cm x 1.5 cm respectively. Followed up for 8 to 12 weeks, the fracture unioned well. CONCLUSION: This operation is simple and reliable, it is characterised by 1. unnecessary to anastomosis the vessels 2. reliable blood supply 3. high quality of bone flap 4. either bone flap or bone-skin flap can be chosen 5. long vessel pedicle.
OBJECTIVE: To investigate the clinical results of transposition of muscular skeletal flap pedicled with straight head of rectus femoris for treatment of avascular necrosis of adult femoral head. METHODS: Eight patients with avascular necrosis of femoral head were adopted in this study. There were 6 males and 2 females, the ages were ranged from 24 to 56 years. According to the criteria of Ficat, there were 5 cases in stage II and 3 cases in stage III. The Smith-Peterson incision was used to expose the capsule of the hip. After complete curettage of the necrotic bone from the femoral head, the muscular skeletal flap pedicled with straight head of rectus femoris was resected and transposited into femoral head. Finally, conventional decompression of head was performed. RESULTS: All the cases were followed up for 1 to 3 years. There were excellent results in 5 cases, good in 2 cases and moderate in 1 case. The rate of excellent and good results were 87.5%. CONCLUSION: Comparing with other pedicled bony flaps, the muscular skeletal flap pedicled with straight head of rectus femoris is characterized by its convenience and efficacy. It is suitable for the treatment of avascular necrosis of femoral head in stage II or III, but the contour of the femoral head should be nearly normal.
It is clear that that bloody bone graft is better than tranditional nobloody bone graft. The autherdesigned the shelf oporation of gluteus minimus muscle pedicle ilinc graft in hip joint. Since 1986 , 14patients were operated. Follow-wp survey lasted 24 to 49 monthes. It was improved evidently forhip joint unsteadiness and clandicatory gait and bad complication did not hiappon. The operation wassimple and make use of materials nearby and union fastly. It didn t destroy myedynamia of ...
Various tissue flaps are currently used to repair the defect and injury of bone and joint. In this paper, based upon a series of anatomical studied, the author presents anatomical guidelines and principles for the selection of vaseularized bone flaps. Under these guidelines, the applied anatomical essential for vaseularized transplantation of ilium, scapula, fibula, costa, tibia, radius, ulna, humerus, femur and clavicle are provided.
In order to explore a new method to treat the ischemic necrosis of the head of 2nd metatarsal bone in adult, transposition of reversed vascularized metatarsal bone graft was adopted in the treatment of 4 cases, 2 of which were followed up for one and a half years. The postoperative X-ray showed the round head of the 2nd metatarsal bone became round and even density. The clinical observation showed that there was excellent function of metatarsophalangeal joint. It was concluded that the reversed vascularized metatarsal bone graft could provide a reliable blood supply and various osteogenic factors to the avascularized head of the metatarsal bone, and the operation could also debride the joint cavity and carry out decompression.