微创打压植骨治疗早中期股骨头坏死疗效分析  

Clinical Analysis of Bone Impaction Grafting Through a Femoral Head- neck Window in Treating Early to Intermediate Stages of Osteonecrosis of the Femoral head

作　　者：高广凌[1] 黄相杰[1] 张钟元[1] 张贵华[1] 徐梓耀[1] 

机构地区：[1]山东省文登整骨医院,山东威海264400

出　　处：《中国伤残医学》2017年第3期1-3,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨经股骨头颈部开窗自体髂骨打压植骨治疗早中期股骨头坏死的临床疗效。方法：自2010年4月～2012年2月，共治疗早中期股骨头坏死26例35髋。男22例，女4例；年龄22～52岁，平均35．7岁。单侧坏死17例，双侧坏死9例。根据ARCO分期，属于IIB－IIIC。平均随访时间为54．6个月（46～68个月）。结果：所有数据经过统计学分析，术前和术后评估显示平均Harris髋关节评分自60．81～88．96分。89．5％ II期患者在X线上显示有改善，100％III 期患者在X线上显示有改善。根据Harris髋关节评分，92．3％的患者为优良。随访期间无患者行人工全髋关节置换。结论：此方法清除死骨彻底，植骨支撑充分，手术创伤小，患者功能恢复快，对于防止或延迟年轻患者行人工全髋关节置换是有效的。Objective： To evaluate the clinical effect of auto - iliae bone - grafting through a window at the femoral head - neck june- tion in treating early to intermediate stages of osteonecrosis of the femoral head. Methods： The study included 26 patients （ 35 hips; 22 males, 4 females; mean age 35.7 years, range 22 - 52 years ; unilateral 17 cases, bilateral 9 cases） with stage liB - IIIC Osteonecrosis of the femoral head according to the system of the ARCO （Association Research Circulation Osseous）. The outcome was determined by the changes in the Harris hip score, by progression in radiographic stages, and by the neec] for hip replacement. The mean follow - up was 31.6 months （range 24 -44 months）. Results： Pre - and postoperative evaluations showed that the mean Harris hip score increased from 60.81 to 88.96. Radiological improvement was noted in 89.5% of patients in stage II and 100% in stages III. Excellent and good results according to the Harris score were obtained in 92.3% of all the cases, and no one performed total hip replacement. Conclusion： Bone impaetion grafting through a femoral head - neck window in treating early to intermediate stages of osteonecrosis of the femoral head has the advantages of debridement thoroughly, better structural support , less tissue damage, quicker postoperative recovery. This procedure may be effective at avoiding or forestalling the need for total hip replacement in young patients with early to intermediate stages of osteonecrosis of the femoral head.

关 键 词：打压植骨 股骨头坏死 临床疗效 

分 类 号：R683.42[医药卫生—骨科学]