Application of fibular flap with partial continuous periosteum and cortex in hip preservation surgery for femoral head necrosis
10.3760/cma.j.cn441206-20210830-00204
- VernacularTitle:保留供区部分连续性骨膜及骨皮质的腓骨瓣在股骨头坏死保髋手术中的应用
- Author:
Mingfei HE
1
;
Yanwen LEI
;
Zhongming HUANG
;
Chuanghao YU
;
Yi LUO
;
Xiang WU
;
Zengyang GAO
;
Jingliang ZHANG
Author Information
1. 广东和迈医院集团顺德和平外科医院显微外科，广东 佛山 528308
- Keywords:
Femoral head necrosis;
Fibular flap;
Hip preservation surgery;
Microsurgical technique
- From:
Chinese Journal of Microsurgery
2021;44(6):625-628
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the short-term clinical effect of using fibular flap with preserving the continuity of fibula in hip preservation surgery for femoral head necrosis.Methods:From September, 2017 to November, 2020, 13 cases of femoral head necrosis were repaired with fibular flap. The fibular flaps were cut with an improved method for preserving the continuity of the fibular cortex, and the donor sites were sutured directly. The fibuls were inserted into the femoral heads with single or double segment folding support. Autogenous iliac crest combined with platelet-rich plasma(PRP) was used for impaction of bone grafting in femoral head, and the fibular flaps were anastomosed with 1 artery and 2 veins. All follow-up data were obtained, including bone union by X-ray and CT as well as the functional recovery of the hip joint and donor site. Statistical analysis was performed. P<0.05 was considered statistically significant. Results:The followed-up time ranged from 6 to 23 months. The fibular bones were significantly thicker and the incisions healed well at the donor sites. There was neither abnormal sensation in toes, dorsal foot, and lateral of the leg, nor significant influence on foot function. The hip joint activities were normal. The outcome was proved to be remarkable according to the Harris score(from 58.9±10.6 points before surgery to 81.7±10.6 points after surgery), the difference was statistically significant ( P<0.05) . Conclusion:The method of the improved fibular flap in hip preservation surgery is beneficial to the repair and reconstruction of the necrotic femoral head since the donor area is less traumatic, and a satisfactory clinical effect can be obtained.
