摘要
[目的]探讨并总结非创伤性股骨头坏死(ONFH)的手术策略及方法,并评估其临床疗效。[方法]回顾性分析2002～2008年间随访资料完整的ONFH患者52例(63髋),男33例,女19例。根据国际骨循环研究学会(ARCO)分期,塌陷前期坏死面积>30%的患者采用小孔径多通道经皮钻孔减压引流术,坏死面积<30%的患者采用钽棒置入+游离髂骨植骨术,塌陷后期患者则接受全髋关节置换。随访结果以Harris评分和并发症作为评价指标。[结果]52例(63髋)患者获得至少36个月随访,Harris评分由术前的平均49.9分提高至术后末次随访时的85.9分,所有病例无感染、神经损伤等并发症。[结论]股骨头坏死手术方式的选择应遵循个体化原则,策略的选择与坏死面积、部位和软骨塌陷程度有关。
[Objective]To explore the appropriate minimal surgical strategy according to the grading system of osteonecrosis of the femoral head（ONFH）,and to evaluate the clinical results of this strategy. [Methods]From January 2002 to December 2008,52 patients（63 hips） were treated in our department.There were 19 female and 33 male cases,17 steriod-induced and 22 alcohol-induced.Then different reconstruction techniques were chosen according to the Association Research Circulation Osteous（ARCO） classification.The patients with stage ⅠC and ⅡC underwent core decompression using percutaneous multiple small-diameter drilling.The patients with type B and A in early stage osteonecrosis of the femoral head received the porous tantalum implant,combined with nonvascularized iliac bone grafting.The patients with stage Ⅲ and Ⅳunderwent THA.Clinical outcomes measures were Harris score and incidence of complication. [Results]Fifty-two patients（63 hips） were followed up for at least 3 years.The average Harris hip score had improved from（49.9±14.6）points preoperatively to（85.9±13.2）points at final follow-up.No complication happened. [Conclusion]Appropriate strategy of minimally invasive surgery should be selected individually in ONFH patients.Surgical strategy is determined by the severity of collapse and lesion region.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2011年第23期1967-1971,共5页
Orthopedic Journal of China
关键词
骨坏死
股骨头
外科手术
osteonecrosis
femoral head
surgery
