CAJ | 학술논문

目的　为治疗胫骨骨不连和骨缺损提供一种新方法。方法　通过解剖学观察膝降动脉关节支及隐支的关系，并摹拟手术证实以隐血管为蒂的逆行股骨内侧髁骨瓣的切取可能。结果　尸体摹拟手术4例，切取后关节支均有墨汁显示。临床应用2例，切取骨瓣分别为5.0 cm×2.0 cm×1.5 cm及4.5 cm×1.5 cm×1.5 cm均有活跃渗血。随访8～12周，骨折愈合良好。结论　应用以隐血管为蒂的逆行股骨内侧髁骨瓣骨皮瓣治疗胫骨骨不连和骨缺损具有手术方法简便，疗效可靠，易于推广等优点。
목적　위치료경골골불련화골결손제공일충신방법。방법　통과해부학관찰슬강동맥관절지급은지적관계，병모의수술증실이은혈관위체적역행고골내측과골판적절취가능。결과　시체모의수술4례，절취후관절지균유묵즙현시。림상응용2례，절취골판분별위5.0 cm×2.0 cm×1.5 cm급4.5 cm×1.5 cm×1.5 cm균유활약삼혈。수방8～12주，골절유합량호。결론　응용이은혈관위체적역행고골내측과골판골피판치료경골골불련화골결손구유수술방법간편，료효가고，역우추엄등우점。
Objective　To investigate a new operative method for repairing nonunion and defect of tibia. Methods　First, observe the relation between the joint branches of descending genicular artery and the saphenous branch of descending genicular artery in 10 cadevers. Then the medial femoral condylar bone flap pedicled with the saphenous vessels was prepared in 4 cadavers for simulated purpose. Clinically, two patients with tibial nonunion were treated by transplantation of this pedicled bone flap. Results　In the 4 simulated operations, the ink which was injected into the femoral artery could be released from the joint branches. And in the clinical operation, the area of the pedicled bone flaps were 5.0 cm×2.0 cm×1.5 cm and 4.5 cm×1.5 cm×1.5 cm respectively. Followed up for 8 to 12 weeks, the fracture unioned well. Conclusion　This operation is simple and reliable, it is characterised by ① unnecessary to anastomosis the vessels ② reliable blood supply ③high quality of bone flap ④ either bone flap or bone-skin flap can be chosen ⑤ long vessel pedicle.