Liang Gui-Cheng, Jia Bin, Ji Jian-Guo
Department of Orthopaedics, Laiyang Center Hospital, Yantai 265200, Shandong, China.
Zhongguo Gu Shang. 2010 Sep;23(9):704-7.
To evaluate the clinical results of continuing skeletal traction and impaction granular bone grafting via window in femoral neck for the treatment of avascular necrosis of femoral head.
From August 2000 to October 2004, 23 patients (35 hips) with femoral head necrosis were treated by continuing skeletal traction and impacting granular bone grafting via bone window on femoral neck. There were 18 males, 5 females, with an average age of 32 years ranging from 19 to 52 years, which included 7 hips of stage II, 28 hips of stage III. All patients had various degrees of hip joint pain and suffered from limited hip motion. The necrotic bone, granulation tissue and hardening zone were completely cleaned via bone window on the femoral neck. The autogenous granular iliac bone was grafted, and impacted persistently. Skeletal traction through femur condyles was applied continually after the operations. The effects before and after operation were compared by the hip pain, function, joint activity and X-ray.
Regular follow-up was carried out after the patients were dismissed from the hospital. The follow-up period was 6 months, 1 year, 2 years, 3 years, 4 years, 5 years respectively. According to Wang's standard, the average score was increased from (52.66 +/- 12.53) preoperatively to (88.94 +/- 5.84) preoperatively at half a year, (89.78 +/- 6.18) at 1 year, (86.37 +/- 7.46) at 2 years, (84.08 +/- 7.57) at 3 years, (83.76 +/- 8.08) at 4 years, and (76.83 +/- 8.98) at 5 years. Scores of operation were greatly increased and the difference had statistical significance.
Continuing skeletal traction after the operation, completely cleaning the necrotic bone and impacting granular bone grafting via window on femoral neck can greatly raise the satisfactory rate of clinical effect and delay the progression of disease for avascular necrosis of femoral head.
评价持续骨牵引联合经股骨颈开窗打压颗粒骨植骨治疗股骨头缺血性坏死的临床疗效。
2000年8月至2004年10月，对23例（35髋）股骨头坏死患者采用持续骨牵引联合经股骨颈骨窗打压颗粒骨植骨治疗。其中男18例，女5例，平均年龄32岁（19～52岁），Ⅱ期7髋，Ⅲ期28髋。所有患者均有不同程度的髋关节疼痛，髋关节活动受限。经股骨颈骨窗彻底清除坏死骨、肉芽组织及硬化带，植入自体颗粒髂骨并持续打压。术后持续经股骨髁行骨牵引。通过髋关节疼痛、功能、关节活动度及X线片比较手术前后的效果。
患者出院后定期随访，随访时间分别为6个月、1年、2年、3年、4年、5年。按王岩标准，术前平均评分（52.66±12.53）分，术后半年为（88.94±5.84）分，1年为（89.78±6.18）分，2年为（86.37±7.46）分，3年为（84.08±7.57）分，4年为（83.76±8.08）分，5年为（76.83±8.98）分。手术评分明显提高，差异有统计学意义。
术后持续骨牵引，彻底清除坏死骨，经股骨颈开窗打压颗粒骨植骨，可大大提高股骨头缺血性坏死的临床疗效满意率，延缓病情进展。
