股方肌蒂骨瓣移植治疗早期股骨头缺血性坏死

Treatment of Ischemic Necrosis of Femoris with Bone Flap with Quadratus Femoris Pedicle Transplantation

目的 探讨股方肌蒂骨瓣移植治疗早期股骨头缺血性坏死的临床经验。方法 实施该手术的病人2 6 6例 ,其中单侧的 2 0 4例 ,双侧的 6 2例 ;男性 2 2 2例 ,女性 4 4例。年龄 2 6～ 6 0岁 ,平均 39岁。病史中有大量服用过激素者 131例 ,过度饮酒者 96例 ,明显外伤者 2 1例 ,无特殊者 18人。结果 症状消失、股骨头复活的2 11例 ,占 6 4 3% ;症状明显缓解、股骨头无进行性坏死的 85例 ,占 2 5 9% ;无效者 :32例 ,占 9 8%。结论 经临床 32 8例手术实践 ,效果比较满意 ,术后三周患髋要保持伸直位 ,术后三个月内患肢避免负重。

Objective To discuss the treatment experiences of ischemic necrosis of femoris with bone flap with quadratus femoris pedicle transplantation. Methods 266 cases of ischemic necrosis of femoris were treated with this method. The clinical data of sex, age, history and symptoms were analyzed. Results The symptoms disappeared and femoris head survived in 211 cases of patients (64.3%). The symptoms alleviated and femoris head had no progressive necrosis in 85 cases (25.9%). The treatment was invalid in 32 cases (9.8%). Conclusion The curative effect of this method was satisfied after 328 cases of operation. The involved hip should maintain extension position within 3 weeks and avoid to be burdened with within 3 months after operation.