股骨颈骨折早期股骨头缺血性坏死的评估

Evaluation of avascular necrosis of the femoral head on early stage of femoral neck fracture

背景:目前以早期评估骨折后股骨头血供的存留作为骨坏死风险的评估指标。目的:总结可早期诊断及评估股骨颈骨折后是否发展为股骨头缺血性坏死的方法。方法:查阅国内外近些年来有关该方面的文献,对超声影像学检测在早期诊断及评估股骨颈骨折后股骨头血供的存在与否及预后中的作用进行综合分析。结果与结论:股骨颈骨折后血供中断是导致骨坏死的主要因素,而超声选择性血管造影、骨内在氧分压检测、多普勒激光血流动力学检测、放射性同位素骨闪烁成像检测及MRI检测可早期诊断血管损伤及评估骨坏死,为影像学分型、预后评估及指导外科手术治疗起了一定的作用。虽然早期诊断股骨颈骨折评估预后的方法较多,但各有利弊,仍需不断改进及寻找更为先进和实用的诊断方法。

BACKGROUND：On current research,the early evaluative index of osteonecrosis risk may be base on the blood reservation of femoral head after fracture.OBJECTIVE：To summarize the methods which can early diagnose and assess whether the femoral neck fractures can result in avascular necrosis of the femoral head.METHODS：We consulted literatures about this aspect in domestic and overseas in recent years in order to summarize the effect of ultrasonography detection in the early diagnosis and assessment of femoral head blood supplying after femoral neck fracture as well as the effect in prognosis.RESULTS AND CONCLUSION：Blood supply interruption after the femoral neck fracture is the major factor of the femoral head necrosis,whereas ultrasound selective angiography,bone inner oxygen partial pressure test,laser doppler hemodynamic detection,the radioactive isotope bone imaging detection and magnatic resonance imaging detection can early diagnose and assess vascular injury and bone necrosis,and play an important role in image typing,the prognosis of the femoral head and conduction of the surgical operation.Although there are plenty of methods to early diagnose and assess the prognosis of the femoral neck fracture,all of these methods may more or less have some drawbacks which still need continuously improvement,and we should search the more advanced and practical methods for early diagnosis.