Consistent With The Free Vascularized Fibular Graft Treatment Of Early Avascular Necrosis

Background: vascular necrosis of the femoral head (ANFH) is a kind of disease that, the pathologic progress of cytoclasis, which caused by the Function of one alone or various factors combined to the bone cell, the marrow builds the blood cell and the lipocytes, lead the destroy of a joint cartilage, femoral head collapse and the joint function lose. At present it is a kind of familiar disease. Because it's heavy illness of coxa joint for femoral head collapse, this disease is very important to be diagnosis and treatment.So far, the treatment methods of ANFH include the no operative treatments and operative treatments.nonoperative treatments include rest, huge-pressure oxygen therapy, stimulation with electricity therapy and Chinese traditional medicine,et. Nonoperative treatments include pure core decompression with or without grafting, core decompression with blood substances, osteotomy, periosteum transplantation with the vessel pedicel, inervention therapy and resurfacing, and so on.When the earlier period of pathological changes and the necrosis of the femoral head is not quite serious, these methods are applicable, and the curative effect are certain relatively. Total hip arthroplasty is applicable to the patients who are in the terminal period, with femoral head collapse, restricted movement, and acute pain. This method includes the pure femoral head replacement and total hip replacement.Objective: Further study the treatment avascular necrosis of the femoral head with free vascularized fibular graft of this surgical method to guide the clinical treatment of ANFH. Method: This text summary 15 cases with ANFH from June of 2006 to Marth of 2008 .They were followed up for an average of 10.5 months, We were compared all the X-ray slides of preoperation's with the postoperation. We discussed the curative effect of this method,Results: All the patients get better within 4 to 6 months. The X-ray showed the increased bone density of the femoral head. No case experienced deterioration. The score was 85.5 before the operation The Harris hip score was 94.5.Conclusion: the indication of this method: 1) the age is relatively younger, generally less than 45 years old; 2)the focus range is smaller ,the necrosis has not more than 15-30percents of the whole femoral head;3)the stage is not more than FicatIII. The avascular necroses of the femoral head treated with free vascularized fibular graft provide chance to THA. Treat the ANFH with free vascularized fibular graft can acquire excellent effect by choosing right sufferers, appropriate opportunity, and the good surgical technique. But it also has shortcoming: difficult procedure, low indications and so on. Therefore this method is an effective therapy for the patients with ANFH.