如何把握股骨头坏死患者的保髋治疗时机
何伟
510105,广州中医药大学第一附属医院骨科
摘要：Hip pain and loss of function are the main complications of progressive collapse. It is known that patients between the age of 30 and 50 are at the highest risk. It is significant to preserve joint on the pre-collapse stage of osteonecrosis of the femoral head ( ONFH ). The indications are: ( 1 ) the time to collapse ( pain ) is less than 6 months; ( 2 ) the degree of collapse is less than 4 mm; ( 3 ) the age is younger than 45 years old; ( 4 ) good hip function; ( 5 ) good compliance. No matter which kind of hip preserving surgery will be cholsen, all should obey the following principles: ( 1 ) fully eliminate the dead bone thus to ensure a good blood supply on the area of the grafted bone; ( 2 ) fullly combinating the impacted bone graft with the sustaining bone graft; ( 3 ) autologous bone grafting material is preferred; ( 4 ) as possible as small exposure and slight trauma; ( 5 ) do not increase the damage of the blood supply of the femoral head; ( 6 ) do not increase the difficulty of the second artificial joint replacement after its primary failure. The foundation of the hip preserving surgery, on one hand, lies on a comprehensive analysis of pathological stage of the disease by combinating the clinical symptoms such as pain with the imaging findings, for example, bone marrow and femoral head interior fracture; on the other hand, the detailed medical history, the gait, the rotation function of the patient are also carefully acquired. The success keypoint of hip preserving surgery of ONFH depends on a timely, accurat diagnosis as well as fully understanding of the pathological changes. Regardless of which kind of method, the treatment for the pre-collapse state is to repair the collapse and also prevent a new collapse at the same time. For the post-collapse state of ONFH, the treatment principle is to completely repair the necrosis, restore the stability in the joint and the femoral head, and build a good matching between the acetabular and the femoral head.
关键词：股骨头坏死骨坏死髋关节矫形外科手术保髋
分类号：R687.4(骨科学（运动系疾病、矫形外科学）)
论文发表日期：2016-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：5( 82-86 )
英文信息