带旋髂深血管蒂髂骨植骨治疗成人股骨头无菌性坏死（附50例报告）  

ABSTRACT Treatment of Aseptic Necrosis of The Femoral Headwith The Deep Circumflex Iliac Vessel Pedicle BoneGrafting

作　　者：姚树源[1] 尚天裕[1] 于建华 朱式仪 马宝通 张建国 顾云五 

机构地区：[1]海南省中医院骨科,中医研究院骨伤科研究所,天津医院创伤骨科

出　　处：《中华骨科杂志》1994年第6期324-329,T001,共7页Chinese Journal of Orthopaedics

摘　　要：本文报告了采用滑膜切除，开窗减压，病骨刮除及同侧带旋髂深血管蒂髂骨植骨综合方法治疗成人股骨头无菌性坏死的长期随访结果。根据Ｍａｒｃｕｓ分期方法，本组５１个髋中，Ⅱ期７个髋，Ⅲ期６个髋、Ⅳ期３２个髋，Ⅴ期６个髋，２６个髋随访三年以上（平均５２．５个月）。临床评价采用改良的Ｊａｃｏｂｓ方法，术前平均为５０分，术后为８６．７分（ｔ＝２．５３５６，ｐ＜０．０５），临床优良率为８８．５％。术后Ｘ线评价显示无１例出现股骨头的进一步塌陷，所有已塌陷的股骨头均有不同程度修复再塑光园现象，Ｘ线修复率为９２．３％。n this paper,the authors present their clinical experi-ence and the long-term results of treatment of the asepticnecrosis of the femoral head in adult with a composite pro-cedute including synovectomy,fenestration,curettage andvaseularized iliac bone graft with the pedicle of the ipeilateral deep circumflex iliac vessels. According to Marcus’staging system,there were 7 stage Ⅱ,6 stage Ⅲ,32 stage Ⅳ and 6 stageⅤ.Of the 5 1 hips in this series,26 werefollowed up more than 3 years(with an average 52,5months),The clinical assessment done based on the modi-fied Jacob’ s rat ing system both before and after thesu rger y show ed tha t the average overall score was in-creased from 50 to 86.7 points(t=2. 5356,P<0. 05),and made an overall excellent and good rate of 88.5%。Post-operative radiological assessment demostrated thatthere was n o incidence of de ter iorat ion or fu rther col la pseof the femoral head and a certain extent of re-spheringand re-surfacing of the head was observed in all of thecollapsed heads. The total radiological re pairing rate was92.3%.

关 键 词：带血管蒂骨瓣 股骨头坏死 骨移植 

分 类 号：R687.3[医药卫生—骨科学]