摘要
目的分析髋关节镜导向器引导下精准钻孔减压治疗早期股骨头坏死的近期临床疗效。方法选取2015-04至2018-08解放军总医院第三医学中心骨科60例(93髋)诊断为股骨头坏死的患者,均接受导向器引导下股骨头坏死区精准钻孔减压治疗。患者18~53岁,平均38.3岁,男44例,女16例。其中激素性股骨头坏死28例,酒精性股骨头坏死11例,8例为武警战士训练后所致,13例不明原因。术前采用Harris评分系统进行患髋评分,术后予以对症治疗,定期随访,拍片复查。结果60例(93髋)获得随访,失访2例,平均随访13个月。Harris评分由术前[(74.19±12.19)分]提高到末次随访时的[(87.40±5.34)分]。其中2例病情进展股骨头发生塌陷。无感染及术中、术后股骨转子间或股骨颈骨折发生。结论导向器引导下股骨头坏死区精准钻孔减压能将钻孔位置精准定位到股骨头坏死区域,提高了钻孔减压的准确性,手术效果好。
Objective To analyze the efficacy of treating early osteonecrosis of the femoral head(ONFH)via hip arthroscope-guided precise drilling decompression.Methods Between April 2015 and August 2018,60 patients(93 hips)who had been diagnosed with ONFH underwent arthroscope-guided precise drilling decompression.These patients(44 males and 16 females)were aged 18 to 53,with an average age of 38.3 years.Among these patients,there were 28 cases of hormone-induced ONFH,11 cases of alcohol-induced ONFH,8 cases caused by military training,and 13 cases of unknown causes.The Harris hip score was used to score the hips preoperatively.Symptomatic treatment and regular follow-up were offered postoperatively.Results Sixty cases(93 hips)were followed up,and two cases lost contact,so the follow-up averaged 13 months.The Harris hip score rose from(74.19±12.19)points preoperatively to(87.40±5.34)points during the last follow-up.Two cases progressed into femoral head collapse.Neither infection nor preoperative or postoperative femoral intertrochanteric fractures occurred.Conclusions Hip arthroscope-guided precise drilling decompression can help locate ONFH accurately,thus improving both the accuracy of drilling decompression and surgical outcomes.
作者
李志国
赵斌
王耀霆
庞兆
赵喆
邢更彦
LI Zhiguo;ZHAO Bin;WANG Yaoting;PANG Zhao;ZHAO Zhe;XING Gengyan(Department of Orthopedic,the Third Medical Center of PLA General Hospital,Beijing 100039,China)
出处
《武警医学》
CAS
2021年第9期765-768,共4页
Medical Journal of the Chinese People's Armed Police Force
关键词
股骨头坏死
钻孔减压
导向器
精准
osteonecrosis of the femoral head
drilling decompression
guider
accurate
