股骨颈骨折后股骨头坏死

Osteonecrosis of the femoral head after femoral neck fracture

简要叙述股骨颈骨折后股骨头坏死的早期诊断和坏死预测等的最新进展。为使骨折后骨坏死尽量减少,早期手术和关节穿刺减压,避免髋关节放置在伸直及内旋位是必要的,建议屈曲位牵引。应用Gd-DTPA增强MRIT1脂肪浸润扫描,可预测股骨头坏死的可能性。建议将股骨头坏死分为静息型骨坏死和临床型骨坏死。

This paper describes briefly the newest progress in the early diagnosis and prediction of the osteonecrosis of the femoral head (ONFH) after femoral head fracture. It is necessary that early operative intervention and aspiration of the intracapsular blood should be done in order to minimize the occurrence of ONFH. It is wise to avoid positioning the hip in extension and internal rotation until surgery. Traction with hip in flexion is recommended. Using the contrast enhanced (Gd DTPA) MRI with T1 fat saturation imaging within 24 hours after injury, the prediction of ONFH will be possible. It is recommended the ONFH should be divided into two types, namely silent and clinical ones.