股骨头内吻合断裂支持带动脉重建血供的可行性研究

目的 探究模型动物股骨头内吻合断裂支持带动脉重建血供的可行性。 方法 选取20例成年家猪髋关节标本，用硫酸钡悬液通过囊外动脉环对股骨头进行灌注，观察各支持带动脉的分布及入股骨头后的走行特点。另20例标本建立头下型股骨颈骨折模型后，在股骨头表面凿一个三角形骨槽，显露头内最粗支持带动脉与股骨颈侧的血管断端进行端端吻合。用硫酸钡悬液检测吻合血管的通畅情况和股骨头的灌注情况。 结果 20例灌注标本可观察到有3组支持带动脉为股骨头供血，各支持带动脉入头后的起始部分沿皮质下走行。向20例头下型股骨颈骨折模型动物的头内吻合的支持带动脉灌注硫酸钡悬液，均能顺利通过吻合口且在持续灌注后股骨头内的其它动脉均有硫酸钡悬液充盈。 结论 股骨头内吻合断裂支持带动脉的方法可行，可以恢复股骨头血供。

Feasibility study on reconstruction of blood supply by anastomosing ruptured retinacular artery in the femoral head

Objective To investigate the feasibility of reconstruction of blood supply by anastomosing ruptured retinacular artery in the femoral head. Methods Twenty cases of fresh hip specimens of adult pig were randomly selected to infuse the femoral head with barium sulfate suspension through the extracapsular arterial ring. The distribution of each retinacular artery and running characteristics after entering the femoral head were observed. In the other 20 cases, the model of subcapital femoral neck fracture was established firstly. On the surface of the femoral head, a triangle bone groove was pried to expose the retinacular artery in the femoral head. The broken end of the blood vessel in the femoral head side were carried out with the broken end of the blood vessel in the femoral neck side by the end-to-end anastomose. Finally, the barium sulfate suspension was used to detect the patency of anastomotic vessels and perfusion of femoral head. Results In the 20 perfused specimens, there were three groups of retinacular arteries supplying blood to the femoral head. After entering the femoral head, the initial parts of the retinacular arteries in the femoral head all traveled along the cortex. In the other 20 cases, the barium sulfate suspension can pass the anastomotic stoma smoothly. After continuous perfusion, other arteries in the femoral head were filled with barium sulfate suspension. Conclusions It is feasible to anastomose the ruptured retinacular artery with the femoral head, which can restore the blood supply of the femoral head.