Zhang Ying, Liu You-Wen, Sun Rui-Bo, Fan Yan-Nan, Shi Qi-Yun, Zhang Lei-Lei, Li Pei-Feng, Li Wu-Yin
Medicine (Baltimore). 2020 Sep 4;99(36):e22106. doi: 10.1097/MD.0000000000022106.
Osteonecrosis of the femoral head is a common orthopedic disease. Based on years of clinical experience and significant imaging data, this study aimed to elucidate a new type of it, to help improve prognosis in young adults and provide a basis for hip preservation treatment.From January 2014 to December 2016, a total of 211 patients undergoing hip preservation surgery for femoral head necrosis at our hospital were enrolled in this study. Coronal plane classification and cross-sectional area analysis were performed by nuclear magnetic resonance imaging (computed tomography optional) in cases meeting the inclusion criteria. Meanwhile, a new method of classification and calculating the necrotic area was proposed. The application simulation was conducted using sample cases. Additionally, treatment methods were recommended. We used our method to compare the outcome of the selected patients with the JIC classification so as to judge the advantages and disadvantages.The " pressure bone trabecular angle " of the femoral head was measured, and the "sclerotic band" (Zhang Ying) type of classification system and the "quartile" (Zhang Ying) method of measurement were used in 2 sample cases. After analysis, it is more accurate than JIC.The "Sclerotic band" type of classification system and 'quartile' methods are new methods to evaluate the stability of femoral head necrosis. They are convenient for clinical application and easily adopted.
股骨头坏死是一种常见的骨科疾病。基于多年的临床经验和大量影像学数据，本研究旨在阐明一种新型的股骨头坏死，以帮助改善年轻患者的预后，并为保髋治疗提供依据。2014年1月至2016年12月，我院共纳入211例行股骨头坏死保髋手术的患者。对符合纳入标准的病例，采用核磁共振成像（可选择计算机断层扫描）进行冠状面分类和截面积分析。同时，提出了一种新的分类方法和坏死面积计算方法。利用样本病例进行应用模拟。此外，还推荐了治疗方法。我们用我们的方法将所选患者的结果与日本骨坏死委员会（JIC）分类进行比较，以判断其优缺点。测量了股骨头的“压力骨小梁角”，并在2例样本病例中使用了“硬化带”（张英）分类系统和“四分位数”（张英）测量方法。经分析，该方法比JIC分类更准确。“硬化带”分类系统和“四分位数”方法是评估股骨头坏死稳定性的新方法。它们便于临床应用且易于采用。
