股骨头坏死患者保留关节治疗效果分析

Treatment effect analysis of retention joint treatment of femoral head necrosis

目的分析股骨头坏死患者保留关节治疗的临床效果。方法股骨头坏死患者112例(123髋)均采取外科方法进行保留关节治疗,治疗方法分别为带旋股外侧血管部位横支大转子骨瓣、带旋股外侧血管部位升支髂骨瓣、带旋股外侧血管部位旋髂深血管蒂髂骨瓣与降支骨膜支骨膜瓣手术。依据患者Ficat分期进行骨科影像学评价,依据患者Harris髋关节评分进行临床效果评价。结果 FicatⅡ期、Ⅲ期、Ⅳ期恢复良好率分别为95.6%、85.7%、53.3%。112例患者治疗后Harris评分均高于治疗前,差异有统计学意义(P<0.05)。结论治疗股骨头坏死时,应用显微外科手段,通过对患者病情程度的分析,选取单纯/联合血管骨瓣转移方法,能收到较好的治疗效果,值得临床推广应用。

Objective To analyze the effect of the retention joint treatment of femoral head necrosis. Methods 112 cases patients （ 123 hips） with femoral head necrosis were taken with retained joint treatment for the surgical method. Treatment methods were the vascular part of the transverse branch of lateral circumflex femoral greater trochanter,the lateral femoral circumflex vessel part of the ascending branch of iliac bone, iliac vascular pedicle iliac bone with the lateral femoral circumflex vessel part and the descending branch the periosteal branch of the periosteal flap surgery. Evaluated the orthopedic imaging based on Ficat staging and evaluated the clinical effect according to the Harris hip score. Results Ficat ]I , ~[ , IV period re- storing good rate was 95.6% ,85.7% ,53.3%. The Harris score of 112 cases patients after treatment were higher than that before treatment, the difference was statistically significant （ P 〈 0.05 ）. Conclusion In the treatment of femoral head necrosis, use microsurgical instruments, analyze the severity of patient, select purely/vascularized bone transfer method, to be able to receive good treatment, worthy of clinical application.