股外侧肌蒂大转子骨瓣移植治疗早中期股骨头坏死的临床疗效分析

Clinical Analysis of Greater Trochanter Bone Flap Pedicled with Lateral Femoral Muscle in the Treatment of Early and Middle Stage Necrosis of Femoral Head

目的:观察股外侧肌蒂大转子骨瓣移植治疗早中期股骨头坏死的临床疗效。方法:选取本院2014年6月至2018年6月股骨头坏死病人共24人27髋,采用股外侧肌蒂大转子骨瓣移植作为手术治疗方式,通过髋关节Harris评分量表及VAS疼痛量表评价患者术前及术后的髋关节功能,从而分析其临床疗效。结果:手术患者均获得随访,随访时间平均为(24.65±3.17)个月(13~35个月),术前髋关节Harris评分为(70.64±1.93)分,其中优2髋,良11髋,中9髋,差5髋,优良率为48.12%;术后髋关节Harris评分为(92.05±0.55)分,其中优6髋,良18髋,中2髋,差1髋,优良率为88.89%,两组差异有统计学意义(P<0.05)。术前及术后VAS评分分别为(4.89±0.15)分和(1.18±0.27)分,两组差异有统计学意义(P<0.05)。结论:股外侧肌蒂大转子骨瓣移植治疗早中期股骨头坏死取得满意疗效,能够改善股骨头的坏死塌陷。

Objective:To observe the clinical efficacy of greater trochanter bone flap pedicled with lateral femoral muscle in the treatment of early and middle stage femoral head necrosis.Methods:Greater trochanter bone flap pedicled with lateral femoral muscle was used to treat femoral head necrosis patients(27 hips in 24 patients)in author’s hospital from June 2014 to June 2018.The Harris hip score scale and VAS pain scale were used to evaluate the hip joint function before and after operation to analyze the clinical efficacy.Results:All patients were followed up.The average follow-up time was(24.65±3.17)months(13 to 35 months).Preoperative Harris hip score was 70.64±1.93,of which 2 hips were excellent,11 were good,9 were fair,and 5 were poor.The excellent and good rate was 48.12%.The Harris score of hip joints after operation was 92.05±0.55,of which 6 hips were excellent,18 hips were good,2 hips were moderate,and 1 hip was poor.The excellent and good rate was 88.89%.The statistically significant difference was found between the two groups(P<0.05).The VAS scores before and after operation were 4.89±0.15 and 1.18±0.27 respectively.The difference was statistically significant(P<0.05).Conclusion:Greater trochanter bone flap pedicled with lateral femoral muscle in the treatment of early and mid-term femoral head necrosis has achieved satisfactory results,which can improve the necrosis and collapse of the femoral head.