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Experimental anatomical basis for a new method of revascularizing the femoral head for the treatment of avascular necrosis
Authors:E P Mel'man  Iu M Iasel'ski?
Abstract:Two series of experiments were performed in rabbits of both sex at the age of 2-6 months. In I series (42 rabbits) the modelling of Perthes' diseases was performed by a lesion produced in the proximal diaepiphysial femoral growth zone. Character and course of pathological processes in the femoral head and neck were studied. They were mainly correspond to 5 clinical roentgenological stages of Perthes' disease. In II series (52 rabbits) with the model of Perthes' disease the suggested operation on revascularization of the femoral head by means of a periosteal muscular graft on a feeding peduncle was applied. Histological, angiological, roentgenological investigations and the method on indication of radioactive phosphorus (P32) demonstrated good vascularizational and reparative properties of the transplant applied. In 50 patients with Perthes' disease the result of a conservative treatment were studied. In 25 patients the operation on revascularization of the femoral head by means of a periosteal muscular transplant on a feeding peduncle was applied according to the technique suggested. The analysis of the treatment results demonstrated that restoration of the femoral bone configuration and that of functioning of the coxofemoral joint occurred sooner, further progressive course of the disease was stopped, duration of treatment was shorter as compared to the conservative methods. The operation suggested could be applied together with other operative methods for treatment of Perthes' disease.
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