股方肌肌骨瓣植入治疗成人股骨头缺血性坏死  

Quadratus femoris muscle pedicled bone grafting for adult avascular necrosis of the femoral head

作　　者：王宏刚 闫宏伟[2] 刘凯[2] 

机构地区：[1]铜川市矿务局中心医院骨科,陕西省铜川市727000 [2]西安交通大学第二医院骨科,陕西省西安市710004

出　　处：《中国组织工程研究与临床康复》2007年第38期7676-7678,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:目前成人股骨头缺血性坏死的手术方法较多,但远期疗效大多不肯定。股方肌肌骨瓣植入术可以治疗成人股骨头缺血性坏死,但需验证其近远期疗效。方法:选择2001-01/2007-01铜川市矿务局中心医院骨科收治的股方肌肌骨瓣植入治疗股骨头坏死患者15例(18髋),均知情同意。术中暴露股方肌及其在股骨近端的附着点,于附着点处凿取骨瓣,骨瓣为4cm×1.5cm×1.0cm的长方形,将骨瓣插入股骨头内,远端用可吸收骨钉固定。术后3,6,12,24个月门诊复查拍患髋正位和蛙式位X射线片,根据临床查体和X射线片表现将手术效果分为优、良、差3级。结果:全部患者均获随访,随访时间4～36个月。近期疗效满意,出院时疼痛症状均缓解,未见手术相关并发症。中远期随访结果优10髋,良6髋,差2髋,优良率88.9%。结论:股方肌肌骨瓣植入术治疗成人股骨头缺血性坏死近远期疗效确切,手术操作相对简单。AIM： Although there are many surgical methods for avascular necrosis of adult femoral head, most of the long-term curative effect is not positive. In this study the curative effect of quadratus femoris muscle pedicled bone grafting on adult avascular necrosis of adult femoral head was investigated. METHODS： Fifteen patients （18 hips） with avascular necrosis of adult femoral head, who received quadratus femoris muscle pedicled bone grafting, were selected from January 2001 to January 2007. In the operation, the quadratus femoris muscle and point of attachment near to femoral bone were exposed to harvest the bone flap （rectangle of 4 cm× 1.5 cm×1.0 cm）. The bone flap was inserted into femoral bone, and the distal bone was fixed with absorbable bone nail. The hip at orthophona and frog position were examined by X-ray at 3, 6, 12, and 24 months after operation, and the surgical effect was divided into excellent, good and poor grades according to the results. RESULTS： All the cases were followed up for 4-36 months. The short term effect was satisfactory. The pain was relived when they discharged, with no related complications found. The middle and long-term results showed that 10 hips were graded excellent, 6 graded good and 2 graded poor. The choiceness rate was 88.9%. CONCLUSION： Quadratus femoris muscle pedicled bone grafting for adult avascular necrosis of femoral head gets assured clinical effects in short and long term and its operation process is rather simple.

关 键 词：骨移植 股骨头坏死 组织移植 

分 类 号：R617[医药卫生—外科学]