| 经颈开窗死骨刮除颗粒骨植骨治疗股骨头缺血性坏死 |
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| 作者 | Author | 单位 | Address | E-Mail |
| 梁贵成 |
LIANG Gui-cheng |
烟台市莱阳中心医院骨科，山东 烟台 265200 |
Department of Orthopaedics,Laiyang Center Hospital,Yantai 265200,Shandong,China |
xupeihua1964@163.com |
| 贾彬 |
JIA Bin |
烟台市莱阳中心医院骨科，山东 烟台 265200 |
Department of Orthopaedics,Laiyang Center Hospital,Yantai 265200,Shandong,China |
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| 纪建国 |
JI Jian-guo |
烟台市莱阳中心医院骨科，山东 烟台 265200 |
Department of Orthopaedics,Laiyang Center Hospital,Yantai 265200,Shandong,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第9期，第704-707页 |
| DOI：10.3969/j.issn.1003-0034.2010.09.019 |
| 基金项目: |
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中文摘要:
目的：探讨经颈开窗死骨刮除、颗粒骨打压植骨、持续骨牵引治疗股骨头缺血性坏死手术治疗的临床疗效。
方法：自2000年8月至2004年10月，收治23例35髋股骨头缺血性坏死患者，男18例，女5例；年龄19～52岁，平均32岁；Ⅱ期7髋，Ⅲ期28髋。所有病例均有不同程度的髋关节痛，患髋均有不同程度的活动受限。经股骨颈开窗，彻底刮除死骨、肉芽组织、硬化带，将自体颗粒状髂骨分次分层打压植入，术后持续股骨髁上骨牵引。通过术前、术后髋关节疼痛、功能、活动度、X线评价比较治疗效果。
结果：出院后定期随访，分别为术后的0.5、1、2、3、4、5年，参照王岩等的百分法进行疗效评价，评分由术前的平均(52.66±12.53)分，提高至术后半年的(88.94±5.84)分，术后1年的(89.78±6.18)分，术后2年的(86.37±7.46)分，术后3年的(84.08±7.57)分，术后4年的(83.76±8.08)分，术后5年的(76.83±8.98)分，术前、术后评分差异有统计学意义。
结论：经股骨颈开窗彻底刮除死骨、颗粒状自体髂骨打压植入、术后持续股骨髁上骨牵引治疗股骨头缺血性坏死，可大大提高股骨头缺血治疗满意率或延缓病情发展。 |
| 【关键词】股骨头坏死 骨移植 骨牵引复位法 外科手术 |
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| Treatment of avascular necrosis of femoral head by impacting granular bone grafting via window in femoral neck |
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ABSTRACT
Objective: To evaluate the clinical results of continuing skeletal traction and impaction granular bone grafting via window in femoral neck for the treatment of avascular necrosis of femoral head.
Methods: From August 2000 to October 2004,23 patients(35 hips) with femoral head necrosis were treated by continuing skeletal traction and impacting granular bone grafting via bone window on femoral neck. There were 18 males,5 females,with an average age of 32 years ranging from 19 to 52 years,which included 7 hips of stageⅡ，28 hips of stageⅢ。 All patients had various degrees of hip joint pain and suffered from limited hip motion. The necrotic bone,granulation tissue and hardening zone were completely cleaned via bone window on the femoral neck. The autogenous granular iliac bone was grafted,and impacted persistently. Skeletal traction through femur condyles was applied continually after the operations. The effects before and after operation were compared by the hip pain,function,joint activity and X-ray.
Results: Regular follow-up was carried out after the patients were dismissed from the hospital. The follow-up period was 6 months,1 year,2 years,3 years,4 years,5 years respectively. According to Wang's standard,the average score was increased from(52.66±12.53)preoperatively to(88.94±5.84)preoperatively at half a year,(89.78±6.18)at 1 year,(86.37±7.46)at 2 years,(84.08±7.57)at 3 years,(83.76±8.08)at 4 years,and(76.83±8.98)at 5 years. Scores of operation were greatly increased and the difference had statistical significance.
Conclusion: Continuing skeletal traction after the operation,completely cleaning the necrotic bone and impacting granular bone grafting via window on femoral neck can greatly raise the satisfactory rate of clinical effect and delay the progression of disease for avascular necrosis of femoral head. |
| KEY WORDS Femur head necrosis Bone transplantation Skeletal tracting reposition Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 梁贵成,贾彬,纪建国.经颈开窗死骨刮除颗粒骨植骨治疗股骨头缺血性坏死[J].中国骨伤,2010,23(9):704~707 |
| 英文格式: | LIANG Gui-cheng,JIA Bin,JI Jian-guo.Treatment of avascular necrosis of femoral head by impacting granular bone grafting via window in femoral neck[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(9):704~707 |
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