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Journal of the Korean Society for Surgery of the Hand 2004;13(2):130-135.
Published online October 31, 2004.
Findings of Digital Subtraction Angiography after Vascularized Fibular Grafting for Osteonecrosis of Femoral Head
Kee-Haeng Lee, M.D., Youn-Soo Kim, M.D., Hae-Giu Lee, M.D.*, Ji-Hoon Ok, M.D., Bae-Kyun Kim, M.D., Hyoung-Min Kim, M.D.
대퇴골두 무혈성 괴사에 대한 혈관부착 비골 이식술 후 디지털 감산 혈관조영술 소견
이기행·김윤수·이해규*·옥지훈·김배균·김형민
Abstract
Purpose: To observe the patency of anastomosis site and the findings of circulation of grafted fibula in osteonecrosis of femoral head treated with vascularized fibular graft by use of digital subtraction angiography.
Materials and Methods: 17 cases of 11 patients who underwent vascularized fibula graft for osteonecrosis of femoral head. We performed digital subtraction angiography(DSA) for them at second week postoperatively in 12 cases, at sixth week in 1 case, at sixth month in 2 cases, at twelfth month in 1 case, and eighteenth month in 1 case which had been got DSA at second week before. We observe the patency of pedicle, and the circulation of grafted fibula such as periosteal and intraosseous vessels with time.
Results: All cases except one which were thought failure of selective angiogram showed good passage of blood flow through anstomosed pedicle on DSA. We found the differences in appearance of circulation of grafted fibula with time. DSA at 2nd and 6th week postoperatively revealed both of periosteal and intraosseous vessels along the fibula and blood pooling at the tip of fibula. DSA at 6th month showed maintenance of periosteal and intraosseous vessels along the fibula but did not clearly reveal blood pooling at the tip of fibula. The findings of DSA at 12th and 18th month were similar each other. The periosteal vessels were not seen as the grafted fibular bone were incorporated into surrounding femoral bone but intraosseous vessels were still seen.
Conclusion: It was thought that DSA could be used for evaluation of the status of pedicle including anastomsed site and vessels of grafted fibula with time. The periosteal vessels of fibula were decreased with time but intraosseous vessels were still seen until 18th month after vascularized fibula graft.
Key Words: Femoral head, Osteonecrosis, Vascularized fibular graft, Digital substraction angiography
 


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