CAJ | 학술논문

背景:由显微外科技术在股骨头坏死治疗的运用中发展而来的带血管蒂大转子骨瓣联合植骨为治疗中青年股骨头缺血性坏死的主要方法之一.目的:通过回顾及分析对于大转子骨瓣移植治疗股骨头缺血性坏死的相关临床及基础研究,从不同层面对大转子骨瓣移植术的研究进行探讨.方法:以“Osteonecrosis Femoral Head、greater trochanter bone flap ”或“Osteonecrosis Femoral Head、 bone flap”或“Osteonecrosis Femoral Head、finite element analysis”为检索词,检索pubmed数据库(1972年1月至2011年10月);以“股骨头坏死、大转子骨瓣”为检索词,检索 CNKI 数据库(1979年1月至2011年10月).选择以大转子骨瓣移植治疗股骨头坏死相关,同一领域文献则选择近期发表或发表在权威杂志文章.根据纳入标准共46篇文章进行综述.结果与结论:关于目前较常用的病灶清除+带旋股外侧动脉横支大转子骨瓣联合打压植骨+游离髂骨瓣植骨治疗股骨头缺血性坏死报道甚少,此术式结合了皮质骨的生物力学优势,同时又有带旋股外侧动脉横支大转子骨瓣加松质骨粒提供良好的血供环境,能很好的解决血供与力学重建的平衡性,达到股骨头的生理重建.
배경:유현미외과기술재고골두배사치료적운용중발전이래적대혈관체대전자골판연합식골위치료중청년고골두결혈성배사적주요방법지일.목적:통과회고급분석대우대전자골판이식치료고골두결혈성배사적상관림상급기출연구,종불동층면대대전자골판이식술적연구진행탐토.방법:이“Osteonecrosis Femoral Head、greater trochanter bone flap ”혹“Osteonecrosis Femoral Head、 bone flap”혹“Osteonecrosis Femoral Head、finite element analysis”위검색사,검색pubmed수거고(1972년1월지2011년10월);이“고골두배사、대전자골판”위검색사,검색 CNKI 수거고(1979년1월지2011년10월).선택이대전자골판이식치료고골두배사상관,동일영역문헌칙선택근기발표혹발표재권위잡지문장.근거납입표준공46편문장진행종술.결과여결론:관우목전교상용적병조청제+대선고외측동맥횡지대전자골판연합타압식골+유리가골판식골치료고골두결혈성배사보도심소,차술식결합료피질골적생물역학우세,동시우유대선고외측동맥횡지대전자골판가송질골립제공량호적혈공배경,능흔호적해결혈공여역학중건적평형성,체도고골두적생리중건.
BACKGROUND:The vascular pedicled greater trochanter bone flap combined with bone grafting developed from the application of microsurgical technique in the treatment of femoral head necrosis is one of the important methods for the treatment of young and middle aged osteonecrosis of the femoral head. OBJECTIVE:To investigate the greater trochanter bone flap transplantation from different aspects through retrospectively analyzing the related clinical and basic research on greater trochanter bone flap transplantation for the treatment of osteonecrosis of the femoral head. METHODS:The PubMed database (1972-01/2011-10) was searched with the key words of“osteonecrosis femoral head, greater trochanter bone flap”or“osteonecrosis femoral head, bone flap”or“osteonecrosis femoral head, finite element analysis”in English;the CNKI database (1979-01/2011-10) was also searched with the key words of“femoral head necrosis, greater trochanter bone flap”in Chinese. The articles that related to the greater trochanter bone flap transplantation for the treatment of femoral head necrosis were selected, and for the articles in the same filed, those published recently or in the authorized journals were preferred. Final y, a total of 46 articles were included for review according to the inclusion criteria. RESULTS AND CONCLUSION:The reports on the commonly used focal cleaning+great trochanter bone flap with the pedicle of the transverse branch of lateral femoral circumflex artery combined with bone grafting+free iliac crest and bone grafting for the treatment of osteonecrosis of the femoral head are rare. This technique can keep the balance between the blood supply and mechanical reconstruction, and can achieve the physiological reconstruction of femoral head with the advantages, such as the biomechanical advantages of the cortical bone and the good blood supply conditions provided by great trochanter bone flap with the pedicle of transverse branch of lateral femoral circumflex artery plus cancel ous.