摘要
目的观察网球支架置入治疗青壮年中晚期股骨头缺血性坏死的疗效。方法采用记忆金属网球支架置入45例患者 (54髋 )坏死塌陷的股骨头内 ,取同侧髂骨松质骨植入网球内顶起已塌陷的股骨头 ,并以带旋髂深动脉及静脉的髂骨骨块封闭股骨头、颈交界处窗口。结果按成人股骨头缺血性坏死的疗效百分评价法对45例54髋随访12～36个月,优良率达88.9 %。结论应用网球支架置入治疗成人股骨头缺血性坏死具有以下优点:(1)彻底清除死骨减压 ;(2)重建股骨头血运 ;(3)增加股骨头负重区软骨下骨的机械支撑 ,降低局部应力 ,有利于股骨头坏死的修复与重建。该方法是对中晚期股骨头缺血性坏死进行修复与重建的一种尝试 ,适用于股骨头坏死FicatⅡ、Ⅲ期患者 ;尤其适用于Ⅲ期股骨头已塌陷但尚未继发骨性关节炎的病例,经网球膨胀、隆起及支撑 。
Objective To explore a new method for treatment of late osteonecrosis of femoral head in adolescence . Methods A tennis ball shaped prosthesis made with shape memory alloy(flexible cage)was implantated into the necrotic area of the femoral head combining a bone graft harvested from the iliac wing with the deep circumflex iliac vascular pedicle of the ipsilateral side in 45 adolescent patients (54 hips). Results Preoperatively, 18 hips were classified as Ficat stage Ⅱlesion and 36 as stage Ⅲ. All the patients were followed up for 12-36 months. Postoperatively,39 patients were pain free,4 had mild pain,and 2 had moderate pain.The radiographic appearance improved in 48 hips. The success rate was 88.9%. Conclusion Tennis ball shaped prosthesis made with shape memory alloy implantation is a better alternative that can prevent the necrotic femoral head from progressing and collapse, recover concentric circles from the collapsed femoral head,and promote revascularization and new bone formation by direct mechanical support. This technique is suitable for the treatment of osteonecrosis of femoral head at stage Ⅱand Ⅲwithout the development of osteoarthritis.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第5期295-298,共4页
Chinese Journal of Orthopaedics
关键词
股骨头缺血性坏死
血运重建
网球支架置入术
Femur head necrosis
Surgical procedures,operative
Braces
Bone transplantation
Blood vessels
Transplantation
Adolescence
