摘要
目的探讨感染后并发股骨头坏死的病因及治疗方法。方法对自1995～2005年收治的6例感染后开发股骨头缺血性坏死患者进行回顾性调查。根据术前术后ARCO分期标准行影像学评价，Harris评分行关节功能恢复评价，并就术中所见及术后病理行病因分析。结果术中及病理证实股骨头呈缺血性坏死改变。X线摄片示6侧患髋均无骨坏死进展表现。Harris评分由术前35．3分恢复到82．6分；本组临床成功率优5例，良1例。结论感染治愈后远期常可并发股骨头缺血性坏死；应用显微外科技术可以清除增生挛缩组织，减轻囊内压力并重建股骨头血运，恢复股骨头外形，是感染治愈后并发股骨头缺血性坏死的一种有效的治疗方法。
Objective To investigate the etiology and microsurgery for post - infection ischemic necrosis of femoral head. Methods A retrospective analysis was conducted in more than one thousand patients with necrosis of femoral head from 1995 to 2005. Six patients were selected and investigated using pathological and biochemical methods. Five got purulent hip arthritis before and one got purulent osteomyelitis before. According to ARCO classification, 2 patients belonged to stage Ⅱ and 3 stage Ⅲ respectively and 1 stage Ⅳ. Results The articular capsule became hyperplasia and thickening, with a narrowing joint space, and a rough and uneven surface of the femoral head during the operation. Pathological exam showed that atrophy or break of trabecular bone, adipose degeneration of marrow and narrowing of blood vessel in the articular capsule. One patient underwent reconstruction of femoral head while 5 patients underwent transplantation of vascularized bone graft. The mean follow - up was 6 years and three months. X - ray showed no continuous progress for the necrosis. The Harris-scores changed from 35.3 to 82.6 and the mean range of motion changed from 67° （0°-80°） to 92° （0°- 110°）. Conclusion Necrosis of femoral head may be complicated by infective factors. The patients can get a better clinical effect and a satisfactory range of motion, and even can be cured using microsurgery therapy.
出处
《中国骨与关节损伤杂志》
2007年第4期283-285,共3页
Chinese Journal of Bone and Joint Injury
关键词
感染
股骨头坏死
骨瓣移植
显微外科
病因
Post - infection
Osteonecrosis of the femoral head
Bone graft
Microsurgery therapy
Etiology
