Department of Orthopaedic Surgery, Ciechanów Hospital, 06-400 Ciechanów, Poland.
Department of Social and Preventive Medicine, Social Medicine Institute, Medical University of Lodz, 90-647 Lodz, Poland.
Int J Environ Res Public Health. 2022 Jun 15;19(12):7348. doi: 10.3390/ijerph19127348.
Avascular necrosis (AVN) of the femoral head is caused by disruption of the blood supply to the proximal femur. The alterations in the blood supply may occur following a traumatic event or result from a non-traumatic cause. Femoral neck fracture and hip dislocation and associated surgical procedures, corticosteroid therapy, and alcohol abuse frequently lead to AVN development. Type of fracture (displaced or undisplaced) and time between injury and surgery are the most critical factors in assessing the risk of developing AVN. Diagnosis of AVN can be established based on patients' complaints, medical history, and radiographic findings. There is no consensus on the treatment of patients with AVN to date. Non-surgical methods are dedicated to patients in the early pre-collapse stages of the disease and consist of pharmacotherapy and physiotherapy. Surgery is recommended for patients with advanced disease.
股骨头缺血性坏死(AVN)是由股骨近端血供中断引起的。血供的改变可能发生在创伤事件后,也可能是非创伤性原因导致的。股骨颈骨折、髋关节脱位和相关的手术操作、皮质类固醇治疗和酒精滥用常常导致 AVN 的发生。骨折类型(移位或未移位)和损伤与手术之间的时间是评估发生 AVN 风险的最重要因素。AVN 的诊断可以基于患者的主诉、病史和影像学发现。目前,对于 AVN 患者的治疗尚无共识。非手术方法适用于疾病早期未塌陷阶段的患者,包括药物治疗和物理治疗。对于晚期疾病的患者,建议进行手术。