头颈开窗联合打压植骨微创治疗早期股骨头坏死

Treating ANFH by surgery

目的:探讨头颈开窗联合打压植骨治疗早期股骨头坏死初步疗效。方法:采用Smith-Petersen切口的一部分作为入路,患肢外旋,在股骨头前内方头颈结合部开窗,根据坏死区域方向,刮除股骨头内坏死骨直至活骨,冲洗后打压植入自身髂骨粒,回植开窗时取下的锥形骨块。结果:经临床应用37例,41个髋关节,随访25～57个月,并按成人股骨头缺血性坏死疗效百分评价法进行评价,优良率为92.3%。结论:头颈开窗联合打压植骨治疗早期股骨头坏死具有以下优点:①手术操作微创,不破坏股骨头本身的血液供应,创伤小。②将死骨彻底清除,植入自身成骨活性较好的骨质,成骨作用强。③对股骨头周围血管翳及炎性组织及时给予清理,有效地阻止其对股骨头进一步侵蚀。④打压植骨增加股骨头坏死区软骨下骨的机械支撑,降低局部应力,有利于早期股骨头坏死的修复及重建。

Objective：To investigate the preliminary efficacy of the window on femoral head and neck combined with impaction bone grafting minimally. Methods：Using the a part of Smith-Petersen incision as an approach, at the head and neck to open the window, curettage necrosis of the femoral head bone, after washing, suppress implant itself iliac tablets, implant the tapered implant bone when opening windows. Results：The clinical application of 37 cases, 41 hips, 25 to 57 months follow-up, according to adult avascular necrosis percentage evaluation method to evaluate the efficacy, the excellent rate was 92.3%. Conclusion：The window on femoral head and neck combined with impaction bone grafting minimally has the following advantages： ①Minimally invasive less invasive. ②The sequestrum completely clear, better activity of the bone implant, bone stronger. ③The surrounding inflammatory tissue timely clean-up, effectively prevent its further erosion of the femoral head. ④Grafting is conducive to early rehabilitation and reconstruction of femoral head necrosis.