为接受髋关节矫形手术的高风险患者制作阔筋膜肌肉瓣

Sofia E Olsson, Isabella Amado, Arman Fijany, Shirin Soleimani, Thomas Troia, Kimberly L Washington, Hugo B Sanchez, Srikanth Kurapati, Maxim Pekarev
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引用次数: 0

摘要

简介:慢性感染和软组织缺损是全髋关节置换术(THA)后的严重并发症,可能需要进行髋关节离断术(HD)。髋关节离断术是一种风险相对较高的手术,长期疗效和存活率较低。这是第一项分析同侧带蒂阔筋膜(VL)肌皮瓣对预防 THA 术后复发并发症患者髋关节脱位的效果的研究:这项回顾性病例研究分析了14名患者术后6个月的疗效,这些患者均由一名外科医生使用VL肌皮瓣进行了软组织髋关节重建:大多数患者(86%)在术后6个月完全康复,髋关节活动范围保持不变,无疼痛,行走无力。尽管采用了 VL 肌瓣,但仍有两名(14%)患者最终需要进行 HD:讨论:VL 肌瓣是治疗不愈合 THA 的有效方法,也是对 HD 高危患者的预防性干预措施。VL肌是最佳选择,因为其体积大,可减少软组织死腔,与髋关节的局部解剖位置相近,且血管丰富。有必要进行更多的前瞻性研究,以确定这项技术最适合的人群。
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Vastus Lateralis Muscle Flap for High-Risk Patients Undergoing Orthopaedic Hip Surgery.

Introduction: Chronic infections and soft-tissue defects are serious complications after total hip arthroplasties (THAs) that may require hip disarticulation (HD). HD is a relatively high-risk procedure with poor long-term outcomes and survival. This is the first study to analyze the effect of an ipsilateral, pedicled vastus lateralis (VL) muscle flap in preventing HD in patients with recurrent complications after THA.

Methods: This retrospective case review analyzed the 6-month postoperative outcomes of 14 patients who underwent soft-tissue hip reconstruction with a VL muscle flap by a single surgeon.

Results: Most (86%) patients fully recovered after 6 months with preserved hip range of motion, no pain, and no weakness on ambulation. Two (14%) patients ultimately required HD despite introducing a VL flap.

Discussion: A VL muscle flap is an effective treatment of nonhealing THA and prophylactic intervention for patients at high risk for HD. The VL muscle is optimal because of its large size allowing reduction of soft-tissue dead space, its local anatomical location to the hip, and its exceptional vascularity. Additional prospective studies are necessary to determine the most appropriate population for this technique.

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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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