摘要
目的 寻求治疗股骨头缺血性坏死的简便而有效的手术方法。方法 设计一种于股骨头颈交界处开窗、坏死骨清除减压、髂骨松质骨填充植骨术 ,术后配合牵引髋关节 ,早期持续被动功能锻炼的方法 ,治疗股骨头缺血性坏死 2 0例 2 9个股骨头。结果 2 0例 2 9个股骨头经 1～ 3年随访 ,效果满意。髋痛消失 ,髋关节功能良好 ,行走及下蹲正常或基本正常。结论 此术式可彻底清除坏死骨 ,消除血供障碍因素 ,为重建血运修复骨质创造条件 ,在病灶清除后的股骨头空腔内 ,填充大量松质骨支撑软骨面 ,为骨修复提供成骨条件。早期髋关节持续被动功能锻炼对关节软骨的修复和预防关节粘连是极为有利的。此法操作简便 ,创伤小 ,效果好。
Objective To explore a simple and effective method for the treatment of ischem ic necrosis of fem oral head.Methods The anterior region of hip joint was exposed by anterior hip route,a1.5 cm× 1.0 cm hole was made at the upper region of the femoral neck just below the head.The necrotic bone and sclerotic bone were completely cleaned by drill and curettage until the fresh cancellous bone was exposed.After irrigation,the bone cavity was filled tightly by iliac bone graft until the collapsed fem oral head recovered its norm al shape.Trac- tion and continuous passive motion(CPM) were performed at the early stage after operation.Results Twenty cas- es with2 9femoral head ischemic necrosis(Marcus to stage) were treated by above m ethods.After1to3 years follow- up,the results were all satisfactory.The pain disappeared,and the functions of the hip jointwere all excellent with alm ost normal walking and squatting.Conclusion The necrotic bone and the sclerotic bone can be removed by this m ethod,thus optimal conditions for the reconstruction of blood supply is obtained.Abundantcan- cellous bone graft in the residual bone cavity can support the round shape of the femoral head.CPM is very impor- tant in the repair of hyaline cartilage and prevention of joint stiffness.It is a sim ple and effective method in treating fem oral head ischem ic necrosis.
出处
《中国修复重建外科杂志》
CAS
CSCD
2000年第2期93-95,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
股骨头坏死
植骨术
病灶清除
Femoral head Ischem ic necrosis Focal cleaning Bone graft
