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International Orthopaedics

, Volume 5, Issue 2, pp 61–68 | Cite as

Vascular microsurgery in orthopaedics

  • H. Judet
  • J. Judet
  • A. Gilbert
SICOT Meeting Rio De Janeiro 1981

Summary

Three applications of free vascularised bone grafts are described. Free fibular grafts have been performed in 19 cases of avascular necrosis of the femoral head. The grafts are placed along the anterior femoral neck and into the femoral head with a microvascular anastomosis between the nutrient vessels of the fibula and the anterior circumflex pedicle of the hip. The operative technique is described but the post-operative follow-up is still too short to draw any definite conclusions.

This operation has been performed in young patients in whom the only alternative would be a total hip replacement.

Free vascularised transfers of iliac crest bone are described for bone defects such as infected nonunions of the tibia with soft tissue and bony loss. Free vascularised fibula grafts have also been employed with cancellous grafting for cystic defects such as fibrous dysplasia and large bone cysts.

The use of free vascularised fibula grafts is also described in four cases of congenital pseudarthrosis of the tibia.

Key words

Microvascular surgery Vascularised free bone grafts Avascular necrosis of femoral head Infected pseudarthroses Bone defect Congenital pseudarthrosis 

Résumé

Les auteurs présentent une technique originale pour le traitement des nécroses de la tête fémorale. La tête fémorale est luxée et par un volet cartilagineux, la nécrose est excisée et remplacée par de l'os spongieux. Une diaphyse péronière est placée à la face antérieure du col et fixée dans le spongieux de la tête fémorale. Ce péroné est revascularisé par des anastomoses micro-chirurgicales.

A propos de 19 cas opérés, les auteurs décrivent la technique et les premiers résultats qui sont encore précoces. Il s'agit là d'une tentative thérapeutique dont nous ne connaîtrons les résultats que dans quelques années.

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References

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    Gilbert A.: Vascularized transfer of the fibular shaft. Int. J. Microsurg. 1, 100–102 (1979)Google Scholar
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    Judet, J., Gilbert, A., Judet, H.: Apport de la micro-chirurgie à la chirurgie osseuse. Chirurgie 104, 921–924 (1978)Google Scholar
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    Judet, J., Judet, H., Gilbert, A.: Essai de revascularisation de la tête fémorale par transplant du péroné pédiculé. S.O.F.C.O.T. Réunion annuelle, Nov. 1979 (suppl. II). Rev. Chir. Orthop. 66 (1980)Google Scholar
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    Restrepo, J., Katz, D., Gilbert, A.: Arterial vascularization of the proximal epiphysis and the diaphysis of the fibula. Int. J. Microsurg. 2, 49–55 (1980)Google Scholar
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    Trueta, J., Harrison, M. H. M.: The normal vascular anatomy of the femoral head in Adult Man. J. Bone Joint Surg. [Br.] 35, 442 (1953)Google Scholar

Copyright information

© Springer-Verlag 1981

Authors and Affiliations

  • H. Judet
    • 1
  • J. Judet
    • 1
  • A. Gilbert
    • 1
  1. 1.ParisFrance

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