转子间外展截骨治疗股骨头坏死塌陷的长期观察  

Femoral valgus osteotomy for treatment of femoral head necrosis

作　　者：史振满[1] 史疆[1] 王鑫[1] 俞洁[1] 张鹏[1] 郭树章[1] 

机构地区：[1]兰州军区乌鲁木齐总医院全军骨科中心,新疆乌鲁木齐830000

出　　处：《创伤外科杂志》2010年第2期143-145,共3页Journal of Traumatic Surgery

摘　　要：目的探索转子间截骨与股骨头坏死塌陷的关系。方法转子间外展截骨治疗股骨头坏死塌陷30例35髋,观察术前、术后X线片和CT片影像变化。测量马蹄角、角赘角和角赘比。健侧10髋马蹄角正常对照。结果转子间外展截骨术使马蹄角与头赘媾和关节。股骨头坏死塌陷组,马蹄角均值(19.88±2.27)°;角赘角均值(30.80±2.09)°;角赘比1.3:1。正常组,马蹄角均值(20.00±1.77)°。两组马蹄角比较,统计学无差异。结论股骨头坏死塌陷椭圆变形,马蹄角不变;行转子间外展30°截骨术,启动头赘马蹄关节。Objective To explore the relation of the inter-trochanteric osteotomy with the femoral head nec- rosis. Methods The 30 cases with 35 hips subjected to femoral head necrosis were treated by the inter-trochanter valgus osteotomy. Pre-operative and post-operative X-ray and CT image changes were observed,and the horseshoe angle, the included angle between the horseshoe angle and the capital drop（ang-drop angle） and the ratio between anteroposterior edge distance of the horseshoe angle and diameter of the capital drop （ ang-drop ratio ） were meas- ured. The horseshoe angles of 10 hips in the uninjured side were taken as the normal group. Results The inter- trochanter valgus osteotomy recovered the functions of horseshoe angle and the capital drop. The femoral head nec- rosis group ： the mean horseshoe angle was （ 19.88 ± 2.27 ） ° ; the mean ang-drop angle was （ 30.80 ± 2.09 ） °; the ang-drop ratio was 1.3 ： 1. The normal group ： the mean horseshoe angle was （ 20.00 ±1.77 ） °. Compared the hor- seshoe angle, there was no significant difference in the two groups. Conclusion The femoral head necrosis collap- ses and shows elliptical deformation, but the horseshoe angle doesn＇t change. To start the capital drop-horseshose joint,the inter-trochanter 30 degrees-valgus osteotomy should be performed.

关 键 词：股骨头坏死 髋关节 截骨 

分 类 号：R681.8[医药卫生—骨科学]