Nursing care of osteopathic robot-assisted vascularized fibular graft for avascular necrosis of femoral head

Abstract

Objective To summarize the nursing experience of osteopathic robot-assisted vascularized fibular transplantation in the treatment of patients with avascular necrosis of femoral head (ANFH). Methods From September 2016 to November 2020, there were 17 ANFH patients (21 hips) in Beijing Jishuitan Hospital undergoing vascularized fibular graft assisted by orthopedic robots. After operation, the patients were given vasodilator, anticoagulant, anti-infective and related nursing care, as well as functional rehabilitation guidance. Results The operation was successful in 21 hips. All patients had no complications such as donor nerve injury and postoperative lower limb venous thrombosis. There was no weight-bearing activity within 3 months postoperatively and partial weight-bearing on crutches between 3 and 6 months. Among 10 patients (12 hips) followed for an average of 15 months, the hip function recovered well in 9 patients, and one bilateral ANFH patient, in whom the right side recovered smoothly, but the left hip joint was painful and restricted. No intra-articular infection and fibular head protrusion were found by arthroscopic exploration in this patient, and the symptoms were relieved after treatment of acetabular osteophyte. Conclusion For the treatment of ANFH with robot-assisted vascularized transplantation, nursing should focus on whether there is nerve injury in the donor area and on postoperative survival of the transplanted fibula. Postoperative functional exercise is an important part of the recovery for limb function.

Keywords

• avascular necrosis of femoral head
• orthopedic robot
• fibula transplantation
• vascular anastomosis
• nerve injury
• baking lamp
• pressure ulcers
• deep vein thrombosis