摘要
目的总结骨小梁金属重建棒植入治疗成人早期股骨头缺血性坏死(avascular necrosis of the femoral head,ANFH)的手术方法及临床疗效。方法2005年3月-2007年1月,采用骨小梁金属重建棒植入治疗28例ANFH患者。男18例,女10例;年龄18～56岁,平均30.6岁。致病原因:创伤性7例,激素性10例,酒精性5例,原因不明6例。单侧22例,双侧6例。左侧18髋,右侧16髋。根据1997年世界骨循环研究学会骨坏死分期标准:Ⅰ期16例16髋,Ⅱ期12例15髋,Ⅲ期1例1髋,Ⅳ期2例2髋。Harris评分为(50.3±2.2)分。病程12～24个月,平均16个月。结果术后患者切口均Ⅰ期愈合,无感染等并发症发生。28例均获随访,随访时间18～36个月,平均26个月。患者术前疼痛及功能受限症状均明显缓解。术后18个月Harris评分为(85.7±2.4)分,与术前比较差异有统计学意义(P<0.05);获优23例,良3例,中2例,优良率92.86%。结论骨小梁金属重建棒植入是治疗早期ANFH的有效方法之一,可最大限度减少并发症,但远期疗效尚待随访观察。
Objective To investigate the operative method of trabecular metal rod implant for the treatment of the early adult avascular necrosis of the femoral head（ANFH） and its clinical e cacy.Methods From March 2005 to January 2007, 28 patients of ANFH were treated by trabecular metal rod implant, including 18 males and 10 females aged 18-56 years old（average 30.6 years old）.The ANFH was induced by trauma in 7 cases, steroid in 10 cases, alcohol in 5 cases and unknown reason in 6 cases.There were 22 cases of unilateral ANFH and 6 of bilateral ANFH, involving 18 left hips and 16 right hips.According to Association Research Circulation Osseous（ARCO） international classi cation of osteonecrosis launched in 1997, 16 cases（16 hips） were classi ed as stage I, 12 cases（15 hips） as stage I, 1 case（1 hip） as stage Ⅲ and 2 cases（2 hips） as stage IV.Harris score was 50.3 ± 2.2 preoperatively.The course of disease was 12-24 months（average 16 months）.Results All wounds healed by rst intention, and no postoperative complication occurred.All the cases were followed up for 18-36 months（average 26 months）.The pain and functional limitation of patients were improved signi cantly.The Harris score was 85.7 ± 2.4 18 months after operation, showing a signi cant di erence when compared with preoperative score（P 〈 0.05）.Twenty-three cases were graded as excellent, 3 as good and 2 as fair, with the excellent and good rate of 92.86%.Conclusion Trabecular metal rod implant is an e ective method for the treatment of early ANFH and can minimize the occurrence of complications, but the follow-up observation of its long-term therapeutic e ect is still needed.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2009年第5期562-565,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
股骨头缺血性坏死
骨小梁金属重建棒
近期疗效
Avascular necrosis of the femoral head
Trabecular metal rod
Short-term therapeutic e ect
