小切口髓芯减压植骨术治疗早期股骨头坏死

目的研究小切口髓芯减压植骨术治疗早期股骨头坏死的临床疗效。方法采用小切口髓芯减压,病变部位病灶清除,自体髂骨松质骨粒填塞病灶清除区,腓骨干植骨予以支撑,治疗早期股骨头坏死16例(21髋)。结果术后髋关节Harris评分,优12例,疼痛消失,不需服用镇痛药,关节活动度良好;良2例,疼痛明显减轻偶尔服用镇痛药;可1例,有改善,疼痛并伴有跛行,需经常服用镇痛药;差1例,术后1年股骨头出现明显塌陷,疼痛重,不能行走,行人工关节置换。Harris髋关节评分由术前的78分提高到术后的91分。结论小切口髓芯减压植骨术对早期股骨头坏死治疗作用确切,能够有效恢复股骨头的骨性力学结构,延缓或防止股骨头塌陷,具有手术简单、创伤小、恢复快、效果确切等优点。

Small incision to core decompression and bone graft in the treatment of femoral head avascular necrosis

Objective To study the therapeutic effect of small incision to core decompression, sequestrum evacuation and bone grafting in the treatment of femoral head avascular necrosis.Methods The 16 cases(21 hips)were treated with small incision to core decompression,sequestrum evacuation and bone grafting.The 16 cases were followed up for 4-20months(10 on average).Results The effects were satisfied in the 15 cases.After operation,Harris rating score showed that excellent in 12 cases, good 2 cases,fair 1 case;poor 1 case.Total scores increased from 78 to 91 points.Conclusion This procedure has such advantages as minimal trauma,simple manipulation,thus is effective in the treatment of femoral head avascular necrosis.