股方肌蒂转子骨瓣移植治疗股骨头缺血性坏死疗效分析

Therapeutic Effect Analysis of Treating Ischemic Necrosis of Caput Femoris with Musculus Quadratus Femoris Pedicel Trochanter Bone Transplanting

目的总结分析股方肌骨瓣移植治疗股骨头缺血性坏死的临床疗效。方法选取Ficat分期Ⅱ、Ⅲ期股骨头坏死59例患者,全部采用股方肌骨瓣移植治疗,术后随访6~24个月。结果本组59例患者共62髋,优23髋,良30髋,可5髋,差4髋,优良率为85.48%,复查X线见移植骨瓣与股骨头融合良好,53个股骨头明显修复,囊性变减少,持重区软骨面高度有所恢复,5个股骨头无明显变化,4个股骨头进一步塌陷。结论股方肌骨瓣移植治疗股骨头缺血性坏死能够明显增加股骨头血供,改善静脉回流,降低骨内压,提供大量成骨因子,修复坏死变形骨质,有效避免或延迟人工全髋关节置换时间,且术后晚期负重与手术效果呈正相关,即术后患肢完全负重时间越晚,患肢功能恢复情况越好。

Objective To summarize clinical curative effect of treating ischemic necrosis of caput femoris with musculus quadratus femoris pedicel trochanter bone transplanting. Methods To select 59 patient who＇s caput femoris has ischemic necrosis in Ficat staging Ⅱ,Ⅲ,they are all treated with musculus quadratus femoris pedicel trochanter bone transplanting,and followed up 24~36 months.Results There are 62 coxas,including 23 best effect,30 better effect,5 good effect,4 less good,the good rate is 85.48%,the bone graft desis the caput femoris well under the X-ray,53 caput femorises are repaired obviously,cystis degeneration reduces.Conclusions To treat ischemic necrosis of caput femoris with musculus quadratus femoris pedicel trochanter bone transplanting can increase blood supply obviously,improve venous return,degrate intraosseous pressure,provide multiple ossification factor,recover necrosis sclerotin,avoid or delay the time of artificial total hip replacement effectly,and the time of postoperative weight loading positive correlate with operative effection,the latter of the affected limb weight loading,the better of the functional recovery.