title: Treatment of osteonecrosis of the femoral head by using the greater trochanteric bone flap with double vascular pedicles.
abstract: The use of the bone flap transfer has been reported to be successful in treatment of patients with early to medium stage (Ficat and Arlet stage I-III) osteonecrosis of the femoral head (ONFH). We examined the vascular anatomy and blood supply of the greater trochanter area and evaluated the feasibility of revascularization of the femoral head by using the bone flap pedicled with transverse and gluteus medius branches of the lateral circumflex femoral artery. Based on the anatomy study, from January 2002 to May 2004, 32 ONFH patients were treated with the greater trochanteric bone flap pedicled with double blood vessels. Fifteen femoral heads were Ficat and Arlet stage II and 17 were stage III. The mean follow-up was 99.5 months. Two of the 32 patients required a total hip replacement due to severe hip pain after surgery. The overall Harris hip score improved from a mean of 55.2 points to 85 points. Our data suggest the procedure is relatively easy to perform, less donor-site morbidity and useful for young patients with stages II to III disease with or without mild collapse of the femoral head.
authors.affiliation: Department of Biomedical Engineering, Dalian University of Technology, Dalian, Liaoning, China.|Department of Orthopaedic Surgery, Zhongshan Hospital of Dalian University, Dalian, Liaoning, China.
authors.forename: Benjie
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Biomedical Engineering, Dalian University of Technology, Dalian, Liaoning, China.|Department of Orthopaedic Surgery, Zhongshan Hospital of Dalian University, Dalian, Liaoning, China.
authors.forename: Dewei
authors.initials: D
authors.lastname: Zhao
authors.affiliation: School of Basic Medical Sciences, Southern Medical University, Guangdong, Guangzhou, China.
authors.forename: Baoyi
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital of Dalian University, Dalian, Liaoning, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000033:anatomy & histology / Q000637:transplantation; D005269:Femur / Q000098:blood supply / Q000637:transplantation*; D005271:Femur Head Necrosis / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000098:blood supply* / Q000637:transplantation; D016896:Treatment Outcome