头颈部开窗个体化病灶清除打压植骨治疗股骨头缺血性坏死体会

目的 探讨利用高速磨钻行头颈部开窗、个体化病灶清除联合打压植骨治疗成人股骨头缺血性坏死的临床疗效.方法 根据手术前MRI上坏死骨的体积测量以及CT片上坏死部位的测定,采用头颈部开窗个体化病灶清除联合打压植骨治疗成人Ⅰ-Ⅲ期股骨头缺血性坏死22例34髋,按照世界骨循环研究学会(ARCO)分期本组Ⅰ期6髋,Ⅱ期22髋,Ⅲ期...

Treatment of ischemic necrosis of the femoral head by fenestration operation through the head-neck junction of the femur,individualized focal cleaning and impaction bone grafting

Objective To explore the clinic effect of treating the adults′ ischemic necrosis of the femoral head by fenestration operation through the head-neck junction of the femur using the high speed drill,individualized focal cleaning and impaction bone grafting.Methods Based on the volume of the necro-bone measured on the MRI image and the necrotic part determined on the CT films,we treated 22 cases(34hips)of the adults with Stage Ⅰ-Ⅲ ischemic necrosis of the femoral head by individualized focal cleaning and impaction bone grafting with fenestration operation through the head-neck junction of the femur.According to the classification of the ARCO,we had 6 hips of Stage I,22hips of Stage II,and 6 hips of Stage III.The patients were followed up 3 months,half a year and one year.The MRI,X-ray and the Harris hip score were done.Results The follow-up period for the patients was 12 to 24 months.According to the Harris hip score,29 hips had excellent result.10 had good result.3 were fair.1 was poor.X-ray films in 28 hips showed the femoral head appearance was good without the further sign of collapse and necrosis.The averagely Harris score increased from preoperative 68 to postoperative 94.Conclusion The treatment of ischemic necrosis of the femoral head by fenestration operation through the head-neck junction of the femur,individualized focal cleaning and impaction bone grafting has the advantage of simple operation,little trauma,quick recovery,and exact effect.