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[一种治疗股骨头缺血性坏死的股骨头血运重建新方法的实验解剖学基础]

[Experimental anatomical basis for a new method of revascularizing the femoral head for the treatment of avascular necrosis].

作者信息

Mel'man E P, Iasel'skiĭ Iu M

出版信息

Arkh Anat Gistol Embriol. 1979 Nov;77(11):32-9.

PMID:518329
Abstract

Two series of experiments were performed in rabbits of both sex at the age of 2-6 months. In I series (42 rabbits) the modelling of Perthes' diseases was performed by a lesion produced in the proximal diaepiphysial femoral growth zone. Character and course of pathological processes in the femoral head and neck were studied. They were mainly correspond to 5 clinical roentgenological stages of Perthes' disease. In II series (52 rabbits) with the model of Perthes' disease the suggested operation on revascularization of the femoral head by means of a periosteal muscular graft on a feeding peduncle was applied. Histological, angiological, roentgenological investigations and the method on indication of radioactive phosphorus (P32) demonstrated good vascularizational and reparative properties of the transplant applied. In 50 patients with Perthes' disease the result of a conservative treatment were studied. In 25 patients the operation on revascularization of the femoral head by means of a periosteal muscular transplant on a feeding peduncle was applied according to the technique suggested. The analysis of the treatment results demonstrated that restoration of the femoral bone configuration and that of functioning of the coxofemoral joint occurred sooner, further progressive course of the disease was stopped, duration of treatment was shorter as compared to the conservative methods. The operation suggested could be applied together with other operative methods for treatment of Perthes' disease.

摘要

在2至6个月大的雌雄兔身上进行了两组实验。在第一组实验(42只兔子)中,通过在股骨近端骨骺生长区制造损伤来模拟佩特兹病。研究了股骨头和颈部病理过程的特征和进程。它们主要对应于佩特兹病的5个临床X线阶段。在第二组实验(52只兔子)中,对于佩特兹病模型,采用了通过带蒂骨膜肌移植进行股骨头血管重建的建议手术。组织学、血管学、X线检查以及放射性磷(P32)示踪法表明所应用的移植具有良好的血管化和修复特性。对50例佩特兹病患者的保守治疗结果进行了研究。对25例患者根据建议的技术采用了通过带蒂骨膜肌移植进行股骨头血管重建的手术。治疗结果分析表明,与保守方法相比,股骨骨骼结构和髋关节功能的恢复更快,疾病的进一步进展得到阻止,治疗时间更短。所建议的手术可与其他治疗佩特兹病的手术方法一起应用。

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