全髋置换与带血运骨瓣移植在治疗中晚期股骨头缺血性坏死的疗效比较  

Comparison of total hip replacement and transplantation of vascularized bone flap graft for the treatment of terminal stage ischemic necrosis of femoral head

作　　者：张合亮[1] 赵德伟[2] 刘美利[1] 朱希芳[1] 

机构地区：[1]滨州医学院附属医院骨科,山东256603 [2]大连大学附属中山医院骨科

出　　处：《岭南现代临床外科》2005年第3期228-230,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的比较带血运骨瓣移植术和全髋关节置换术治疗中晚期股骨头缺血性坏死的优缺点及临床疗效。方法1986年7月～1991年1月间,作者采用带血运骨瓣移植术和全髋关节置换术治疗中晚期股骨头缺血性坏死患者81例89髋,通过追踪复查、问卷调查等手段共收集59例64髋患者的相应临床资料。其中采用带血运骨瓣移植术治疗36髋,全髋关节置换术治疗28髋。结果随访时间12年3个月～16年7个月,平均15年4个月。术后早期Harris评分全髋组优于骨瓣组;后期Harris评分低龄骨瓣组及高龄全髋组相对较高,而再次手术率则相对较低。结论对于中晚期股骨头缺血性坏死,带血运骨瓣移植术适合于年轻患者;全髋关节置换术适合于高龄患者。Objective To compare the clinical efficacy and advantage and disadvantage of transplantation of vascularized bone-flap graft （TVBG） and total hip replacement （THR） in the treatment of terminal stage ischemic necrosis of femoral head. Methods From July 1986 to January 1991, 81 patients （89 hips） with terminal stage ischemic necrosis of femoral head received either TVBG or THR were reviewed. Among them 59 patients （64 hips） were followed-up after operation. 36 hips were performed with TVBG, 28 hips were performed with THR. Results The follow-up period ranged from 12 years and 3 months to 16 years and 7 months （mean, 15 years and 4 months）. In postoperative early stage, the Harris-score of THR was higher than that of TVBG. In the anaphase, the Harris-score of TVBG of young patients and THR of old patients were higher, and the reoperation rate was lower. Conclusion TVBG is fit for young patients, and the THR is fit for old patients.

关 键 词：骨坏死 股骨头 全髋关节置换 骨瓣 比较 

分 类 号：R687.4[医药卫生—骨科学]