成人股骨头缺血坏死病理X线对照分析

PATHOLOGICAL AND RADIOLOGICAL COMPARISON OF AVASCULAR NECROSIS OF THE FEMORAL HEAD IN ADULTS

对5例成人股骨头缺血坏死标本进行了病理X线对照观察。X线上示位于股骨头承重区的高密度死骨及周围并行的透光带和硬化带;组织学显示,死骨区内全部骨小梁和骨髓组织坏死,多数骨小梁断裂嵌插,透光带区以大量纤维肉芽组织为主,并伴有骨小梁稀疏和(或)吸收碎片,硬化带区坏死骨小梁粗大或新骨沉积。并对X线密度改变的病理基础、复发性坏死的发病机制和坏死骨的修复途径进行了讨论。

Pathologically and radiologicaly comparative observation of 5 cases of ava- scular necrosis of the femoral head in adults was made. In the load-bearing area on the head of femur, all parts of the bone were found necrotic radiologically, most of the trabeculae being broken up and stacked up. The lucent belt around the sequestrum consisted mainly of a great deal of fibrous and granular tissue, which might be accompanied by rare trabeculae and/or absorbed pieces. Thicke- ning dead trabeculae and/or formation of new bone on them appeared in the area of the sclerotic belt. The pathological basis of X-ray density changes and patho- genesis of recurrent necrosis are discussed. A way of repairing the necrotic bone is suggested.