带血管腓骨移植对Ⅱ、Ⅲ期股骨头坏死患者疼痛及步态功能的影响

Effect of vascularized fibula transplantation on pain and gait function in patients with stage Ⅱ and Ⅲ femoral head necrosis

目的分析带血管腓骨移植对Ⅱ、Ⅲ期股骨头坏死患者疼痛及步态功能的影响。方法选取本科收治的Ⅱ、Ⅲ期股骨头坏死患者20例(24髋关节),均行带血管腓骨移植治疗,分析患者治疗效果、疼痛程度和步态功能改善情况。结果20例患者术后6个月膝关节功能优良率为87. 50%;Ⅱ期、Ⅲ期患者术前、术后7 d VAS评分比较差异均有统计学意义(P <0. 05);Ⅱ期、Ⅲ期患者术后7 d VAS评分均明显低于术前(P <0. 05);Ⅱ期、Ⅲ期患者术前步态功能评分比较差异均有统计学意义(P <0. 05);Ⅱ期、Ⅲ期患者术后6个月的步态功能评分显著高于术前(P <0. 05)。结论Ⅱ、Ⅲ期股骨头坏死患者疼痛明显,步态功能受到一定影响,但III期患者疼痛及步态功能受损更严重。因此,带血管腓骨移植可有效减轻患者疼痛程度,改善其步态功能。

Objective To analyze effect of vascularized fibula transplantation on pain and gait function in patients with stage Ⅱ and III femoral head necrosis. Methods A total of 20 patients （24 hip joints） with necrosis of femoral head in stage Ⅱ, Ⅲ were all treated with vascularized fibula transplantation. Treatment efficacy, pain level and gait function improvement of two groups were analyzed. Results The excellent and good rate of knee function in 20 patients was 87.50%. There were no significant differences in VAS scores before treatment and after 7 d of treatment between stages Ⅱ and Ⅲpatients（ P 〈0.05）. The VAS scores of two staged patients were significantly lower than operation before （ P 〈0.05）. The gait function score before treatment for stages Ⅱ and III patients showed significant difference （ P 〈0.05）, and was significantly higher at 6 months after operation than operation before（ P 〈0.05）. Conclusion The pain of stage Ⅱ and Ⅲ patients with femoral head necrosis is obvious, and the gait function is affected to some extent. The pain and gait function are more serious in stage Ⅲ. Vascularized fibula transplantation can relieve pain and improve gait function.