摘要目的 带血管蒂楔骨瓣转移联合髂骨植骨术治疗非外伤性距骨缺血性坏死并评价其疗效.方法 自2000年1月至2005年6月,应用带血管蒂楔骨瓣转移治疗非外伤性距骨缺血性坏死20例,男14例,女6例;年龄22～58岁,平均42.5岁;按照改良的Ficat and Arlet分期标准,Ⅱ期8例;Ⅲ期10例;Ⅳ期2例.结果 随访14～68个月(平均37个月),按Kenwright等的疗效标准进行评定,优8例;良10例;可1例;差1例.临床症状完全或部分缓解,术后骨坏死区全部被新生骨组织填充,术后优良率为90%.结论 带血管蒂楔骨瓣转移髂骨植骨术是治疗非外伤性距骨缺血性的较为理想的方法,值得临床应用.

abstractsObjective To evaluate the outcome of cancellous bone grafting plus iliac cancellous bone in the treatment of non-traumatic avascular talar necrosis.Methods Twenty patients,14 males and six females,eight at stage Ⅱ,ten at stage Ⅲ and three at stage Ⅳ according to the modified Ficat & Arlet necrosis classification system,were treated with vascularized bone flap from January 2000 to June 2005.Results All patients were followed up for a mean of 37 months(range:14 to 68 months).The clinical function outcome evaluated by Kenwright criteria were excellent in 8 cases,good in 10 cases,fair in 1 case and poor in 1 case.Clinical symptom Was completely or partially relieved.The necrotic area was fiIled with newly formed bone and the excellent-to-good rate was 90%.Conclusion Transposition of vascularized cuneiform bone flap plus iliac cancellous bone grafting may be an ideal therapeutic method for non-traumatic avascular talar necrosis.And the clinical outcome is satisfactory.