| 股骨颈骨折对局部血供的损伤及评估——解剖基础及其临床运用进展 |
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Received:January 08, 2023
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| 作者 | Author | 单位 | Unit | E-Mail |
| 吴升辉 |
WU Sheng-hui |
上海交通大学医学院附属第六人民医院, 上海 200233 |
Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200233, China |
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| 缪语 |
MIAO Yu |
上海交通大学医学院附属第六人民医院, 上海 200233 |
Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200233, China |
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| 朱晓中 |
ZHU Xiao-zhong |
上海交通大学医学院附属第六人民医院, 上海 200233 |
Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200233, China |
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| 李广翼 |
LI Guang-yi |
上海交通大学医学院附属第六人民医院, 上海 200233 |
Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200233, China |
guangyi.li@shsmu.edu.cn |
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| 期刊信息：《中国骨伤》2023年36卷，第3期，第294-298页 |
| DOI：10.12200/j.issn.1003-0034.2023.03.020 |
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| 股骨颈骨折内固定的稳定性可在很大程度上通过手术技巧及内固定排布和植入骨替代物等方法获得,但当前医疗技术水平尚无法完全逆转骨折产生的血供损伤。因此,在围手术期,全面评估股骨颈骨折后局部残余血供以避免医源性损伤成为了目前研究的热点。关于股骨颈骨外层面血供的解剖研究相对成熟,其运用主要涉及旋股内侧动脉和支持带动脉的评估,但不同损伤程度的预后需要进一步探索。当前,临床上尚无法直接观察到骨面的滋养孔,但可根据其分布的密集次序、进行合理的术前规划,尽可能保护残存血供,以避免后续股骨头坏死的发生。而骨内血供的解剖基础及临床研究主要聚焦于头颈结合区,以探究股骨头坏死的机制。但关于股骨颈的其它区域骨内血管分布及交联机制仍需要进一步探究。此外,后续研究可根据骨外血管走行、滋养孔分布及骨内血管网的特征建立完善的基于三层次结构综合的血供评估体系,用于辅助股骨颈骨折的治疗。 |
| [关键词]:股骨颈骨折 解剖 血管 滋养孔 |
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| Assessment of the local blood supply when femoral neck fracture occurs:advances in the anatomy research and its clinical application |
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| Abstract:The stability of internal fixation of femoral neck fractures can be obtained through surgical techniques,the configuration of screws and bone grafting,etc. However,the blood supply injury caused by fractures could not be completely reversed by the current medical management. Hence,the comprehensive evaluation of the residual blood supply of the femoral neck,to perioperatively avoid further iatrogenic injury,has become a hotspot. The anatomy of the extraosseous blood supply of the femoral neck has been widely reported,while its clinical application mostly involved the assessment of the medial circumflex femoral artery and retinacular arteries. However,further studies are needed to explore the prognosis of patients with these artery injuries,with different degrees,caused by femoral neck fractures. Direct observations of nutrient foramina in vivo are not possible with current clinical technologies,but it is possible to make reasonable preoperative planning to avoid subsequent femoral head necrosis based on the distribution features of nutrient foramina. The anatomy and clinical application studies of the intraosseous blood supply focused on the junction area of the femoral head and neck to probe the mechanism of femoral head necrosis. Thus,the intraosseous blood supply of other regions in the femoral neck remains to be further investigated. In addition,a blood supply evaluation system based on a three-level structure,extraosseous blood vessels,nutrient foramina,and intraosseous vascular network,could be explored to assist in the treatment of femoral neck fractures. |
| KEYWORDS:Femoral neck fracture Anatomy Blood vessel Nutrient foramina |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴升辉,缪语,朱晓中,李广翼.股骨颈骨折对局部血供的损伤及评估——解剖基础及其临床运用进展[J].中国骨伤,2023,36(3):294~298 |
| 英文格式: | WU Sheng-hui,MIAO Yu,ZHU Xiao-zhong,LI Guang-yi.Assessment of the local blood supply when femoral neck fracture occurs:advances in the anatomy research and its clinical application[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(3):294~298 |
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