骨瓣移植配合中药治疗成人早期股骨头缺血性坏死

Transplantation of bone flap combined with traditional Chinese medicine in treating the adult premature ischemic necrosis of femoral head

目的探讨骨瓣移植配合中药治疗成人早期股骨头缺血性坏死（ANFH）的疗效。方法成人ANFH患者45例48髋，均行头颈开窗、死骨清除、带血供骨膜骨瓣并松质骨骨髓植入术，手术前后配合口服中药。术后随访3个月至6a，观察疗效。结果48髋中优29髋，良11髋，可5髋，差3髋，优良率83．33％，总有效率93．75％。结论带血管蒂骨膜骨瓣并松质骨及骨髓移植，彻底清除死骨和减压，配合中药治疗，可恢复股骨头血运及股骨头外形，适宜于FicatⅠ～Ⅱ期青壮年ANFH患者。

Objective To study the curative effects of transplantation of bone flap combined with traditional Chinese medicine in treating the adult premature ischemic necrosis of femoral head （ANFH）. Methods 48 hips in 45 patients with ANFH were operated by fenestration, scavenging sequestra, and with blood supplying periost and bone flap and spongy bone marrow implantation. All of patients were asked to take traditional Chinese medicine in pre-operation and post-operation. All patients were followed-up for 3 months to 6 years＇ in order to study the curative effect. Results In the 45 cases,the excellent results was achieved in 29 hips, the good results in 11 hips, the fair results in 5 hips and the poor results in 3 hips. The excellent and good rate was 83.33 % , and the total effective rate was 93.75 %. Conclusion The myo-peduncle bone flap and spongy bone marrow transplantation, scavenge sequestra completely and decompress combined with traditional Chinese medicine, the blood supply and the shape of femoral head can be restored. It is effective in the treatment of patients between twenty and fifty with ANFHat Ficat Ⅰ～Ⅱ.