临床论着带血管蒂髂骨膜瓣移植术治疗儿童股骨颈陈旧性骨折黄恺.DOCVIP

临床论著 带血管蒂髂骨膜瓣移植术治疗儿童股骨颈陈旧性骨折 黄恺 王子明 杜全印 王雨 吴思宇 王爱民* （重庆 400042 第三军医大学大坪医院野战外科研究所骨科） [摘要目的 探讨带血管骨膜瓣治疗儿童股骨颈骨折并评估其疗效。 方法 200年月至201年月股骨颈陈旧性骨折共例并股骨头坏死5例年龄1（～）岁；男性例，女性例。Garden分型：III型例，IV型例。手术先切开复位空心钉内固定，再采用带旋髂深血管髂骨瓣移植治疗例、部分带阔筋膜张肌骨膜瓣移植治疗例。 结果 例随访～月；例患者X线提示股骨颈骨折愈合，5例股骨头坏死患者股骨头修复。按Ratliff标准评价：优例（%），良5例（%）。 结论 带血管骨膜瓣治疗儿童股骨颈骨折是一种有效的好方法；部分带阔筋膜张肌骨膜瓣移植治疗股骨头坏死是一种损伤小、特别适合儿童的新手术。R726.8；R683.42；R687.4+3 The vascularized iliac periosteal bone-flaps graft in treatment of old fractures of femoral neck in children HUANG Kai, WANG Ziming, DU Quanyin, WANG Yu, WU Siyu, WANG Aimin（Department of , Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042, China） Corresponding author: WANG Aimin, E-mail: trauma2@163.com 【Abstract】Objective To the clinical efficiency of old fractures of femoral neck in children treated with vascularized iliac periosteal bone-flaps graft accompanied by internal fixation. Methods From May 2009 to April 2013, a total of 9 children (5 with the avascular necrosis of femoral head) suffering from old fractures of femoral neck were enrolled in this study. There were 6 male and 3 female. The mean age was 13.7 years (ranging from 9 to 18 years). According to Garden classification, 4 hips were indentified as type III and 5 as type IV. Iliac periosteal bone-flaps graft with deep circumflex iliac vessel was performed in 4 patients and iliac periosteal bone-flaps graft with partial tensor fasciae lata in 5. Results All patients were followed up over a mean period of 40.8 months (ranging from 11 to 94 months). All the fractures were healed. According to Ratliff evaluation criteria, 4 patients were assessed as excellent and 5 as good. Conclusion The vascularized iliac periosteal bone-flaps graft accompanied by internal fixation is an effective method to treat old fractures of femoral neck in children. Iliac periosteal bone-flaps graft with partial tensor fasciae lata is a new and effective procedure to treat fractures of femor