同种异体骨在股骨颈内固定取出后钉道内植骨中的临床应用

The clinical application of allogeneic bone in internal jugular fixed femoral nail out with bone graft

目的探讨同种异体骨在股骨颈内固定取出后钉道内植骨中的临床应用。方法选择行股骨颈内固定取出后钉道内植骨的患者108例,将患者随机分为2组各54例。自体组采用自体腓骨联合打压植骨进行治疗,异体组采用同种异体骨联合打压植骨进行治疗。比较2组髋关节功能、疼痛程度、生活质量情况及术后并发症情况。结果治疗前2组患者Harris评分、视觉模拟疼痛评分(VAS)及日常生活质量评分(ADL)对比差异均无统计学意义(P>0.05),治疗后2组Harris评分和ADL评分均升高,VAS评分均降低,与治疗前比较差异均有统计学意义(P<0.05);但2组间比较差异均无统计学意义(P>0.05)。异体组患者并发症发生率为5.55%低于自体组的14.81%,差异有统计学意义(P<0.05)。结论同种异体骨植骨和同种同体骨治疗股骨颈骨折效果均较好,患者生活质量明显提高,但同种异体骨并发症发生率更低,值得临床应用及推广。

Objective To study the clinical effect of allograft bone and impacted graft in the treatment of femoral head necrosis after the removal of fixture of femoral neck. Methods 108 patients with femoral head necrosis were divided into two groups randomly,with 54 cases of each group. The autologous group adopted the autogenous fibula graft and impacted graft; the allograft group adopted the allograft bone graft（ allograft bone） and impacted graft. The hip function,pain degree,quality of life and postoperative complications were compared between the two groups. Results before treatment,Harris score,visual analogue score（ VAS） and the quality of daily life（ ADL） score comparison showed no significant difference between the two groups（ P〉0. 05）; after treatment,Harris score and ADL score were significantly increased,VAS scores were reduced,compared with before treatment,the differences were statistically significant（ P〈0. 05）; but there was no statistically significant difference between the two groups（ P〉0. 05）. The complication rate of the allogeneic group（ 5. 55%） was lower than that of the autologous group（ 14. 81%）,the difference was statistically significant（ P〈0. 05）. Conclusion The effect femoral neck fracture with allogeneic bone graft and allograft bonein treatmentfemoral head necrosis after the removal of fixture of femoral neck are both good,the quality of life of patients is significantly improved,but the incidence of complications of allogeneic bone is lower,which is worthy of clinical application and promotion.