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目的：本文结合应用髂嵴游离复合瓣修复口腔下颌骨缺损的体会，对髂嵴游离瓣的解剖、制作、适应性及优缺点等问题进行了论述。方法：我科所用髂嵴游离瓣均以旋髂深血管为蒂进行移植，携带皮岛者，尚吻合旋髂浅静脉。制作时，采用顺行解剖法，由血管蒂的近心端向远心端解剖，截取大小合适的髂嵴块。结果：１９７９年１０月～１９９７年８月，共进行髂嵴游离瓣移植手术１１０例，成功１０６例，４例失败，成功率９６．３％。结论：髂嵴游离瓣适用于口腔肿瘤术后，口腔－下颌骨的一期重建。但由于皮岛的血供难以预测，因而即使吻合旋髂浅静脉，皮岛的成活率仍有限。髂嵴游离瓣近年来有被腓骨游离瓣取代之势。
OBJECTIVE: In this paper, the application of iliac crest free composite flap to repair oral mandibular defect was reviewed. The anatomical, fabrication, adaptability, advantages and disadvantages of the free flap of iliac crest were discussed. Methods: The free iliac crest used in our department were all transplanted with the deep iliac circumflex iliac artery. Production, the use of antegrade anatomy, from the proximal end of the vascular pedicle to the distal end anatomy, interception of the appropriate size iliac crest blocks. Results: From October 1979 to August 1997, 110 cases of iliac crest free flap transplantation were performed successfully, 106 cases were successful, 4 cases failed and the success rate was 96.3%. Conclusion: The iliac crest free flap is suitable for primary reconstruction of oral and mandibular tumors after oral tumor surgery. However, due to the unpredictable blood supply of the skin island, the survival rate of the skin island is limited even if the iliac vein is well aligned. In recent years, the free iliac crest flap has been replaced by the free flap of the fibula.