Schwetlick G, Weber U, Klingmüller V
Unfallchirurg. 1989 Feb;92(2):73-8.
Revascularisation surgery was performed in six cases following medial femoral neck fracture with femoral head necrosis and non-union of the femoral neck. A corticospongiosis pelvic graft supplied by the deep circumflex iliac artery was implanted as an autologous heterotopic pedicled transplant. The operative procedure was the same in all cases, since it was possible to lift out the pelvic graft from the same side as the affected hip joint, thus making a microvascular anastomosis unnecessary. Follow-up examination after 15-27 months revealed that, in all cases, osseous consolidation of the pseudarthrosis had been achieved and that further segmental collapse of the contour of the femoral head had been prevented. The angiographic studies performed during the examination demonstrated unimpeded circulation in the pedicle of the transplants in five of the six cases, as long as 3 months after the operation. For the first time it was possible in these five cases, by means of a transplant angiograph, to demonstrate integration of the graft into the biologically weak post-traumatic transplant region.
对6例股骨颈内侧骨折合并股骨头坏死及股骨颈骨不连的患者实施了血运重建手术。将由旋髂深动脉供血的皮质松质骨骨盆移植物作为自体带蒂异位移植植入。所有病例的手术操作相同，因为可以从患侧髋关节的同一侧取出骨盆移植物，因此无需进行微血管吻合。15至27个月后的随访检查显示，所有病例的假关节均已实现骨愈合，且防止了股骨头轮廓的进一步节段性塌陷。检查期间进行的血管造影研究表明，6例中有5例在术后长达3个月时，移植骨蒂部循环通畅。在这5例中，首次通过移植血管造影显示移植物融入了创伤后生物力学薄弱的移植区域。
