带血管蒂髂骨膜瓣移植术治疗儿童股骨颈陈旧性骨折-第三军医大学学报.DOCVIP

PAGE PAGE 1 带血管蒂髂骨膜瓣移植术治疗儿童股骨颈陈旧性骨折临床分析 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 探讨带血管蒂髂骨膜瓣移植联合内固定治疗儿童股骨颈陈旧性骨折并评估其临床疗效。 方法 2009年5月至2013年4月儿童股骨颈陈旧性骨折共9例，其中合并股骨头坏死5例。年龄13.7（9～18）岁；男性6例，女性3例。Garden分型：（Ⅲ）型4例，（Ⅳ）型5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4例、部分带阔筋膜张肌骨膜瓣移植治疗5例。 结果 9例全部获得随访，平均随访40.8（11～94）个月；9例患儿X线提示股骨颈骨折愈合良好，5例股骨头坏死患儿股骨头修复。按Ratliff标准评价：优4例（44.4%），良5例（55.6%）。 结论 带血管蒂髂骨膜瓣治疗儿童股骨颈陈旧性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儿童股骨颈骨折及儿童股骨头坏死是一种损伤小、特别适合儿童的新手术。 [关键词] 股骨颈陈旧性骨折；股骨头坏死；阔筋膜张肌；旋髂深血管；骨瓣；儿童 [中图分类号] R726.8；R683.42；R687.4+3 [文献标志码] A 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 Orthopedics, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042, China） [Abstract] Objective To evaluate the clinical efficiency of vascularized iliac periosteal bone-flaps graft accompanied by internal fixation in treating 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 boys and 3 femalegirls. The mean age was 13.7 years (ranging from 9 to 18 years). According to Garden classification, 4 hips were indentified identified 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 bon