Free vascularized iliac bone flap based on deep circumflex iliac vessels graft for the treatment of osteonecrosis of femoral head

作者：Pengfei Lei, Wei Du, Hao Liu, Panfeng Wu, Zhengbing Zhou, Fang Yu, Liming Qing, Ding Pan, Rui Liu, Lei Zeng, Zheming Cao, Qifeng Ou, Juyu Tang · 发表于：Journal of Orthopaedic Surgery and Research · 年份：2019 · DOI：10.1186/s13018-019-1440-2 · 被引用次数：31 · 研究领域：Bone and Joint Diseases、Hip disorders and treatments、Lower Extremity Biomechanics and Pathologies

BACKGROUND: To investigate the feasibility and clinical efficacy of free vascularized iliac bone flap based on deep iliac circumflex vessels graft for the treatment of osteonecrosis of femoral head (ONFH) in young adults. METHODS: Eighteen patients (19 hips) undergoing ONFH were included from January 2016 to May 2017. After the debridement of the necrotic bones, the contralateral vascularized iliac bone flap was designed and harvested before grafting, in which the deep circumflex iliac vessels and the transverse branch (or ascending branch) of the lateral circumflex femoral artery and their accompanying veins were anastomosed. X-ray was obtained at 1, 3, 6, 9, and 12 months respectively for evaluation of the bone flap healing. Hip function was evaluated with Harris hip score at 18 months postoperatively. RESULTS: None of the patients is lost to follow-up. All the hips healed well except for four complications: one patient developed superficial wound infection, one patient had subcutaneous hematoma, and two patients developed anterolateral femoral cutaneous nerve injury. X-ray films at 12 months showed improvement in 13 hips (68.4%), five hips (26.3%) were unchanged, and one femoral head collapse with conversion to total hip arthroplasty (THA) at 14 months postoperatively (5.3%). Postoperative mean Harris hip scores were significantly improved compared to the preoperative results (P < 0.05). CONCLUSION: Free vascularized iliac bone flap based on deep circumflex iliac vessels g...