成人股骨头坏死保头保髋关键技术——股骨头前外侧柱识别与重建  

The key point of adult hip preservation to femoral head necrosis:recognize and reconstruct anterolateral column of the femoral head

作　　者：罗殿中 张洪 程徽 李勇 张振东 张建立 任宁涛 LUO Dian-zhong;ZHANG Hong;CHENG Hui;LI Yong;ZHANG Zhen-dong;ZHANG Jian-li;REN Ning-Tao(Senior Department of Orthopedics,the Fourth Medical Center of Chinese PLA General Hospital,Beijing,100048,China)

机构地区：[1]中国人民解放军总医院第四医学中心骨科医学部,北京100048

出　　处：《中国骨与关节杂志》2024年第10期769-773,共5页Chinese Journal of Bone and Joint

摘　　要：股骨头坏死是我国常见病,患病人群约800~1200万^([1]),成人股骨头坏死的主要致病因素有创伤、应用糖皮质激素、酗酒;其它致病因素有减压病、吸烟、高脂血症、妊娠、戈谢病(Gaucher disease)、放疗化疗等^([2])。股骨头坏死的病理机制尚不明了,一般分为创伤性股骨头坏死和非创伤性股骨头坏死。创伤性股骨头坏死可能原因:股骨头动脉或静脉血管损伤,关节腔填塞导致血流障碍,股骨头髓微血管内皮损伤,微血管内血栓,等。Along with efforts and development for half century,we come to a new era in the prevention and treatment of femoral head necrosis(FHN).At present,early femoral head necrosis is more easily detected with the economic development,improvement of living standards,updating and popularizing of medical equipment,and contributions of former orthopedic experts.The authors brought up that the key point of hip preservation to femoral head necrosis was to recognize and reconstruct the anterolateral column of the femoral head.There are several effective methods to reconstruct anterolateral column of the femoral head,including basicervical femoral neck rotational osteotomy(BCFNRO or BCRO),intertrochanteric varus osteotomy(ITVO),intertrochanteric rotational osteotomy(TRO),iliac bone support autograft(IBSG)to anterolateral column of the femoral head via surgical hip dislocation(SHD),etc.The tasks in clinical practice on FHN include early detection of the FHN,exact assessment of the collapse risk,effective follow-up and personalized treatment on time based on precise stage and type.Furthermore,pathological mechanism,penetrated molecular biology research,accurate biomechanics analysis,damage and repair of the cartilage of FHN,and artificial intelligence(AI)should be carried out soon.

关 键 词：股骨头坏死 分期 分型 保髋 

分 类 号：R684[医药卫生—骨科学]