摘要
目的:探讨股骨头髓心减压加异体腓骨移植术治疗早期股骨头缺血性坏死的临床疗效。方法:2004年1月至2008年11月治疗Ⅰa～Ⅲb期股骨头缺血性坏死25例32髋,其中男17例,女8例,年龄20～55岁,平均39.1岁。采用股骨头髓心减压加异体腓骨移植、空心拉力螺钉内固定治疗。术前疼痛时间2～14个月,平均5.5个月。所有患者于术前术后行常规X线片、MRI检查、Harris评分。结果:25例均获随访,时间24～48个月,平均36.4个月。X线片显示18例21髋改善,4例6髋不变,关节面未塌陷,2例3髋恶化,1例2髋失败,总有效率84.4%。Harris评分术前(77.0±8.0)分,术后(90.6±2.5)分,差异有统计学意义(t=1.67,P<0.05)。结论:股骨头髓心减压加异体腓骨移植术治疗早期股骨头缺血性坏死,创伤小,关节功能影响小,术后卧床时间短,恢复快,临床症状改善,其短期疗效肯定,中长期疗效仍需进一步观察。
Objective ：To investigate the clinical efficacy of the pith decompression of the femoral head and fibular allograft transplantation in the treatment of early stage avascular necrosis. Methods：From January 2004 to November 2008,32 hips of 25 patients with avascular necrosis of femoral head of Ⅰa- Ⅲ b period were treated by the pith decompression of the femoral head and fibular allograft transplantation, hollow lag screw fixation, included 17 males and 8 females, aged from 20 to 55 years old （39.1 years on average）. Preoperative pain was from 2 to 14 months （means 5.5 months）. All patients were applied on conventional X-ray films, MRI examination, Harris score. Results：The patients were followed up for 12 to 48 months （means 36.4 months）. X-ray film showed 21 hips of 18 cases improved, 6 hips of 4 cases unchanged, no collapse of articular surface, 3 hips of 2 cases deterioration, 2 hips of 1 case failed. Preoperative Harris score was （77.0 ±8.0） and postoperative （90.6± 2.5）, there was a significant difference （t=1.67 ,P〈0.05）. Conclusion：Pith decompression of the femoral head and fibular allograft transplantation in the treatment of early stage avascular necrosis of femoral head has advantage of joint function in bed-ridden after a short time, quick recovery, clinical symptoms improved. Its short-term efficacy is certain but long-term efficacy is still need further observation.
出处
《中国骨伤》
CAS
2009年第8期628-630,共3页
China Journal of Orthopaedics and Traumatology
关键词
股骨头坏死
减压
骨移植
Femur head necrosis
Decompression
Bone transplantation
