摘要
股骨头坏死(ONFH)是一个骨科常见病,也是最难治愈的骨科疾病,目前尚没有公认的根本治愈的方法。ONFH的早期治疗,需要考虑的影响因素众多,如ONFH发生的时间、ONFH的范围、是否已经塌陷以及塌陷程度、治疗ONFH的方法及术者所掌握技术的熟练程度等,都会影响ONFH的治疗效果。目前,针对ONFH早期的治疗,尚未达成统一的治疗原则或共识,医师往往根据自己所掌握的知识、技能以及经验确定其治疗方式。保守治疗方法可能会减轻症状,但没有充分证据证明能够治愈ONFH。ONFH保头手术方法很多,如股骨头髓心减压(单孔、多孔)、股骨头髓心减压加骨移植材料填充和(或)结构性骨支撑、带血管的腓骨移植、带血管的髂骨骨瓣移植、粗隆间旋转截骨或内外翻截骨、ONFH的血管融通术等治疗方法,这些治疗方法有效,但各家报道的临床效果不一,因而也没有取得业内的共识。笔者根据自己多年治疗早期ONFH的临床研究和经验,并结合国内外治疗早期ONFH的现状作一综述,阐述了各种治疗方法的优缺点以及尚存的问题,以引起对早期ONFH的治疗方法的重新思考和探讨。
Osteonecrosis of the femoral head(ONFH)is a common osteopathic disease,and one of the hardest to cure.There are many influencing factors to be considered in the early treatment of ONFH,such as the time and scope of the occurrence of ONFH,whether the ONFH has collapsed and the degree of collapse,the treatment methods for ONFH and the technical means mastered by the surgeon,etc.At present,there is no unified treatment principle or consensus for the early treatment of ONFH.Conservative treatment may reduce symptoms,but there is no enough evidence(moderate-strong evidence)to cure osteonecrosis.ONFH of head surgery such as:femoral head pith decompression(puckering,porous),femoral head pith decompression and bone graft material filling and/or structural support,with vascular fibula graft,bone iliac bone flap with vascular transplantation,intertrochanteric rotary cut bone,or internal and external double cut bone and blood vessels of the ONFH treatment such as financing operation procedure does not have obtained the consensus of the industry.Based on the authors′own experience in the treatment of early ONFH,and combines with the current situation of the treatment of early ONFH at home and abroad,this review provides a reference for the correct treatment of early ONFH.
作者
郭晓忠
岳聚安
Guo Xiaozhong;Yue Ju′an(Department of Orthopaedic, Aviation General Hospital of China Medical University, Beijing 100012, China)
出处
《中华损伤与修复杂志（电子版）》
CAS
2020年第2期81-83,共3页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
关键词
股骨头坏死
保守治疗
手术治疗
Femur head necrosis
Conservative treatment
Surgical treatment
