Zhang B, Zhu S, Guo Y
Department of Orthopedic Surgery, General Hospital of PLA, Beijing, P. R. China 100853.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2000 Mar;14(2):93-5.
To explore a simple and effective method for the treatment of ischemic necrosis of femoral head.
The anterior region of hip joint was exposed by anterior hip route, a 1.5 cm x 1.0 cm hole was made at the upper region of the femoral neck just below the head. The necrotic bone and sclerotic bone were completely cleaned by drill and curettage until the fresh cancellous bone was exposed. After irrigation, the bone cavity was filled tightly by iliac bone graft until the collapsed femoral head recovered its normal shape. Traction and continuous passive motion(CPM) were performed at the early stage after operation.
Twenty cases with 29 femoral head ischemic necrosis (Marcus III to IV stage) were treated by above methods. After 1 to 3 years follow-up, the results were all satisfactory. The pain disappeared, and the functions of the hip joint were all excellent with almost normal walking and squatting.
The necrotic bone and the sclerotic bone can be removed by this method, thus optimal conditions for the reconstruction of blood supply is obtained. Abundant cancellous bone graft in the residual bone cavity can support the round shape of the femoral head. CPM is very important in the repair of hyaline cartilage and prevention of joint stiffness. It is a simple and effective method in treating femoral head ischemic necrosis.
探索一种治疗股骨头缺血性坏死的简单有效方法。
采用髋关节前入路暴露髋关节前部区域，在股骨头下方股骨颈上部制作一个1.5厘米×1.0厘米的骨孔。用钻头和刮匙彻底清除坏死骨和硬化骨，直至露出新鲜的松质骨。冲洗后，用髂骨移植紧密填充骨腔，直至塌陷的股骨头恢复正常形状。术后早期进行牵引和持续被动运动（CPM）。
采用上述方法治疗20例29个股骨头缺血性坏死（Marcus III至IV期）患者。经过1至3年的随访，结果均令人满意。疼痛消失，髋关节功能均为优良，行走和下蹲几乎正常。
该方法可清除坏死骨和硬化骨，从而获得重建血供的最佳条件。在残留骨腔内大量的松质骨移植可支撑股骨头的圆形形状。CPM在透明软骨修复和预防关节僵硬方面非常重要。这是一种治疗股骨头缺血性坏死的简单有效方法。
