| 钽棒植入治疗成人早期股骨头坏死 |
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Received:December 16, 2010
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| 期刊信息：《中国骨伤》2011年24卷，第6期，第482-485页 |
| DOI：10.3969/j.issn.1003-0034.2011.06.012 |
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目的：探讨一种简单有效治疗成人早期股骨头缺血性坏死的新方法，以避免股骨头进一步塌陷和坏死，改善临床症状。
方法：自2009年1月至2010年6月采用钽棒植入治疗9例(10髋)成人早期股骨头坏死，男7例，女2例；年龄29～63岁，平均44.1岁。术前均摄髋关节正侧位X线片，行CT和MRI扫描。按Steinberg分期：Ⅰ期1例1髋，Ⅱa期4例5髋，Ⅱb期4例4髋。手术在C形臂X线机定位下进行，从股骨大转子下钻入导针到股骨头坏死区中心，空心钻沿导针扩髓，刮除坏死区死骨，必要时植骨，选择合适长度的钽棒拧入，支撑坏死区关节面。术后3、6、9个月随访，采用JOA评分标准评价临床疗效，摄髋关节正侧位X线片，观察股骨头变化。
结果：手术时间40～60 min,平均50 min;出血量60～100 ml,平均80 ml.术后无感染、骨折及下肢深静脉血栓形成等并发症，全部病例获得随访，时间9个月及以上，定期行X线检查未发现股骨头塌陷和坏死加重。JOA评分从术前平均(31.30±19.63)分增加至术后3个月平均(54.10±13.20)分，术后6个月(69.90±15.04)分，术后9个月(87.00±8.83)分。
结论：钽棒植入治疗成人早期股骨头坏死手术简单易行，能有效避免坏死区股骨头塌陷，近期疗效满意。 |
| [关键词]:股骨头坏死 外科手术 X线 |
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| Treatment of adult early femur head necrosis with the tantalum screw |
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Abstract:
Objective: To investigate a new method for the treatment adult early femur head necrosis in order to avoid further collapse and necrosis and improve the clinical symptoms.
Methods: From January 2009 to June 2010,10 hips of 9 patients,including 7 males and 2 females,aged from 29 to 63 years old(averaged 44.1),with femur head necrosis were treated with implantation of the tantalum screw. The X-ray film,CT scan and MRI were performed before operation. According to Steinberg staging,stage I was in 1 case (1 hip),stageⅡa in 4 cases(5 hips),stageⅡb in 4 cases(4 hip). With the C-arm X-ray conducted guide,wire was drilled into the center of femur head necrosis regions from the greater trochanter bottom,hollow bodkin enlarged marrow along the guide wire,scraped necrosis sequestrum,transplanted bone if necessary,then implantated the appropriate tantalum screw to prop up the articular surface. The patients were followed up at 3rd,6th,9th month postoperatively,the clinical effects were evaluated according to the JOA criteria,and the changes of the femoral head were observed by X-rays.
Results: The mean operative time was 50 min(ranged from 40 to 60 min);the mean blood loss was 80 ml(ranged from 60 to 100 ml). There was no complications,such as postoperative infection,fracture,deep vein thrombosis and so on. All patients were followed up more than 9 months. No aggravation in collapse and necrosis were found by regular X-ray examination. Postoperative JOA score increased month by month. JOA scores increased obviously from preoperative(31.30±19.63)to(54.10±13.20),(69.90±15.04),(87.00±8.83) at the 3,6,9 months after operation,respectively.
Conclusion: The tantalum screw implantation is simple and effective for the treatment of adult early femur head necrosis,and can effectively avoid collapse of necrotic area,the results were satisfactory in the near future. |
| KEYWORDS:Femur head necrosis Surgical procedures,operative X-rays |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 罗华云,陈崇伟.钽棒植入治疗成人早期股骨头坏死[J].中国骨伤,2011,24(6):482~485 |
| 英文格式: | LUO Hua-yun,LUO Hua-yun.Treatment of adult early femur head necrosis with the tantalum screw[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(6):482~485 |
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