打压支撑植骨术治疗塌陷前期股骨头坏死疗效分析  被引量:1

Clinical Analysis about Impacting Bone Graft Treating Pre-collapse Stage ONFH

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作  者:段瑞奇[1] 何伟[2] 蔡桦[1] 

机构地区:[1]广州中医药大学第三附属医院,广东广州510240 [2]广州中医药大学第一附属医院,广东广州510405

出  处:《中医正骨》2013年第8期3-6,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘  要:目的:回顾性分析打压支撑植骨术治疗塌陷前期股骨头坏死的临床疗效,分析比较影响疗效的因素。方法:回顾性分析连续性塌陷前期股骨头坏死患者,共44例47髋,其中ARCO II B34髋,Ⅱc13髋,酒精性28例30髋,激素性16例17髋。两组患者均接受打压支撑植骨术治疗,随访24~56个月,中位数41.5个月。结果:末次随访Harris评分(85.3±15.7)分,优良率72.3%,有效率89.4%。术后正位共有23髋(48.9%)未塌陷,34髋(72.3%)塌陷〈2mm。ARCO II B34髋术后有13髋发生塌陷,其中3髋塌陷〉4mm;ARCO II C13髋术后11髋发生塌陷,其中4髋塌陷〉4mm。其中酒精性20髋,激素性4髋发生塌陷。最终有2髋转向全髋关节置换术。结论:采用打压支撑植骨术治疗塌陷前期股骨头坏死可以有效预防坏死股骨头塌陷,根据本组数据坏死范围和原因对治疗效果有预测作用。Objective:To evaluate the effect of impacting bone graft in treating pre-collapse stage ONFH with retrospective study. Methods :44 (47 hips) consecutive ONFH cases involving 34 ARCO lIB hips, 13 Ⅱ C hips, 28 ( 30 hips) alcohol-induced cases and 16 ( 17 hips ) steriod-induced cases were treated by impacting bone graft. The follow up time was 24 - 56 ( averaged 42) months. Results : The afarris score was 85.3 ±15.7 at the last follow up,the excellent and good rate was 72.3% ,effective rate was 89.4%. At anterior-posterior X-ray,no collapse was showed in 23 hips(48.9% ) ,collapse 〈2 mm was showed in 34 hips (72.3%). 13 ARCO Ⅱ B hips showed collapse, and 〉4 mm was showed in 3 hips, 13 ARCO Ⅱ C hips collapsed, and 〉 4 mm 4 hips. 20 alcohol-induced hips collapsed, and 4 steriodinduced hips collapsed. 2 hips converted to total hip arthroplasty. Conclusion: Using impacting bone graft can effectively prevent collapse of the pre-collapse stage ONFH. The stage and lesion size play an important role on therapeutic method selection and prognosis.

关 键 词:股骨头坏死 塌陷 手术治疗 

分 类 号:R687.3[医药卫生—骨科学]

 

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