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[股骨头缺血性坏死的外科治疗]

[Surgical treatment of avascular necrosis of the femoral head].

作者信息

Li F, Xu S, Shi S

机构信息

Orthopeadic Department, General Hospital of Beijing, Beijing Unit of People's Liberation Army.

出版信息

Zhonghua Wai Ke Za Zhi. 1995 May;33(5):292-4.

PMID:7587696
Abstract

71 patients (83 hips) with avascular necrosis of the femoral head were followed up. The patients had bilateral necrosis (12), and unilateral (59). Their ages ranged from 19 to 71 years. Ficat classification showed stage I for 1 hip, stage II 19 hips, stage III 35 hips, and stage IV hips. According to the severity, the range of motion, the age, and the X-ray appearances, 6 kinds of procedures were used including decompression with bone grafting (32 hips), surface arthroplasty with cartilage (4), surface arthroplasty with fascia (4), replacement of femoral head (7), THA (20), and obturator neuroetomy (16). The follow-up period ranged from 2 years and 3 months to 10 years and 5 months. Postoperative improvement included pain (39.7%), range of motion (21.7%), and walking (33.7%). Among the procedures, decompression with bone grafting showed best results. Treatment revealed better results in stage I, II than in stage III, IV. We emphysize the early diagnosis and management, and choice of procedure should base on the clinical classification.

摘要

对71例(83髋)股骨头缺血性坏死患者进行了随访。患者中双侧坏死12例,单侧坏死59例。年龄范围为19至71岁。Ficat分期显示,I期1髋,II期19髋,III期35髋,IV期髋。根据病情严重程度、活动范围、年龄及X线表现,采用了6种手术方法,包括带骨移植减压术(32髋)、软骨表面置换术(4髋)、筋膜表面置换术(4髋)、股骨头置换术(7髋)、全髋关节置换术(20髋)及闭孔神经切断术(16髋)。随访时间为2年3个月至10年5个月。术后改善情况包括疼痛(39.7%)、活动范围(21.7%)及行走能力(33.7%)。在这些手术方法中,带骨移植减压术效果最佳。治疗显示I期、II期的效果优于III期、IV期。我们强调早期诊断和处理,手术方法的选择应基于临床分期。

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