Richards R R
Division of Orthopaedic Surgery, Department of Surgery, St Michael's Hospital, Canada.
Semin Arthroplasty. 1991 Jul;2(3):198-207.
Vascularized fibular grafting decompresses the femoral head, augments structural stability, and places healthy vascularized bone in the area of femoral head necrosis. Patients are selected for the procedure on the basis of symptomatology, age, mobility of the hip, and radiographic stage of the disease. Twenty-four patients were reviewed in the current report. Mean patient age was 33. Seven patients had stage II disease, 4 patients had stage III disease, 10 had early (less than 2 mm collapse) stage IV disease, and 1 had stage V disease. The mean follow-up was 32.8 months (range, 24-54 months). Five procedures failed. The remaining patients have had gratifying results in terms of pain relief, functional improvement, and cessation of disease progression. Longer follow-up will determine if vascularized fibular grafting alters the natural history of the condition and if vascularization of the fibular bone graft offers superior results to those obtained in the past with nonvascularized grafts.
带血管蒂腓骨移植可减轻股骨头压力，增强结构稳定性，并在股骨头坏死区域植入健康的带血管骨。根据症状、年龄、髋关节活动度和疾病的影像学分期来选择接受该手术的患者。本报告回顾了24例患者。患者平均年龄为33岁。7例为Ⅱ期疾病，4例为Ⅲ期疾病，10例为早期（塌陷小于2毫米）Ⅳ期疾病，1例为Ⅴ期疾病。平均随访时间为32.8个月（范围24 - 54个月）。5例手术失败。其余患者在疼痛缓解、功能改善和疾病进展停止方面均取得了满意的结果。更长时间的随访将确定带血管蒂腓骨移植是否会改变该病的自然病程，以及腓骨骨移植的血管化是否能提供比过去非血管化移植更好的效果。
