Department of Plastic Surgery, University Hospital of North Durham, Durham, UK.
Microsurgery. 2010;30(1):19-23. doi: 10.1002/micr.20695.
Free fibular bone grafting is an effective treatment for early osteonecrosis of the femoral head in young patients. However, recipient vessels are often small rendering microvascular anastomosis difficult. We have developed a novel technique using retrograde flow through the branches of the lateral circumflex femoral artery to use the proximal end of the artery as the recipient vessel. A vessel diameter of up to 5 mm is obtained providing a good match with the peroneal vessels. We used this technique to perform vascularized bone grafting of the femoral head in 10 patients with Ficat grade 2 and 3 osteonecrosis. Pulsatile retrograde flow from the lateral circumflex femoral artery was observed in each case. Retrospective review gave a median follow up of 52 months (range 17-99). Symptoms improved in all 10 cases. There was no radiological deterioration over the period of follow-up in eight cases. One patient underwent conversion to a total hip replacement 24 months after surgery. These results compare favorably with other studies. The lateral circumflex femoral artery turnover technique is a reliable and useful technique in vascularized bone grafting of the femoral head.
游离腓骨骨移植是治疗年轻患者早期股骨头坏死的有效方法。然而，受区血管往往较小，使得微血管吻合困难。我们开发了一种新的技术，利用旋股外侧动脉分支的逆行血流，将动脉的近端作为受区血管。可以获得直径达 5 毫米的血管，与腓骨血管很好地匹配。我们使用这种技术对 10 例 Ficat 2 期和 3 期股骨头坏死患者进行了带血管骨移植。在每个病例中都观察到来自旋股外侧动脉的搏动性逆行血流。回顾性分析的中位随访时间为 52 个月（范围 17-99 个月）。10 例患者的症状均有改善。在随访期间，8 例患者的影像学无恶化。1 例患者在手术后 24 个月行全髋关节置换术。这些结果与其他研究相比具有优势。旋股外侧动脉翻转技术是一种可靠且有用的技术，可用于股骨头的带血管骨移植。
