CAJ | 학술논문

目的：探讨头颈开窗联合打压植骨治疗早期股骨头坏死初步疗效。方法：采用Smith-Petersen切口的一部分作为入路，患肢外旋，在股骨头前内方头颈结合部开窗，根据坏死区域方向，刮除股骨头内坏死骨直至活骨，冲洗后打压植入自身髂骨粒，回植开窗时取下的锥形骨块。结果：经临床应用37例，41个髋关节，随访25～57个月，并按成人股骨头缺血性坏死疗效百分评价法进行评价，优良率为92.3%。结论：头颈开窗联合打压植骨治疗早期股骨头坏死具有以下优点：①手术操作微创，不破坏股骨头本身的血液供应，创伤小。②将死骨彻底清除，植入自身成骨活性较好的骨质，成骨作用强。③对股骨头周围血管翳及炎性组织及时给予清理，有效地阻止其对股骨头进一步侵蚀。④打压植骨增加股骨头坏死区软骨下骨的机械支撑，降低局部应力，有利于早期股骨头坏死的修复及重建。
목적：탐토두경개창연합타압식골치료조기고골두배사초보료효。방법：채용Smith-Petersen절구적일부분작위입로，환지외선，재고골두전내방두경결합부개창，근거배사구역방향，괄제고골두내배사골직지활골，충세후타압식입자신가골립，회식개창시취하적추형골괴。결과：경림상응용37례，41개관관절，수방25～57개월，병안성인고골두결혈성배사료효백분평개법진행평개，우량솔위92.3%。결론：두경개창연합타압식골치료조기고골두배사구유이하우점：①수술조작미창，불파배고골두본신적혈액공응，창상소。②장사골철저청제，식입자신성골활성교호적골질，성골작용강。③대고골두주위혈관예급염성조직급시급여청리，유효지조지기대고골두진일보침식。④타압식골증가고골두배사구연골하골적궤계지탱，강저국부응력，유리우조기고골두배사적수복급중건。
Objective:To investigate the preliminary efficacy of the window on femoral head and neck combined with impaction bone grafting minimally. Methods:Using the a part of Smith-Petersen incision as an approach, at the head and neck to open the window, curettage necrosis of the femoral head bone, after washing, suppress implant itself iliac tablets, implant the tapered implant bone when opening windows. Results:The clinical application of 37 cases, 41 hips, 25 to 57 months follow-up, according to adult avascular necrosis percentage evaluation method to evaluate the efficacy, the excellent rate was 92.3%. Conclusion:The window on femoral head and neck combined with impaction bone grafting minimally has the following advantages: ①Minimally invasive less invasive. ②The sequestrum completely clear, better activity of the bone implant, bone stronger. ③The surrounding inflammatory tissue timely clean-up, effectively prevent its further erosion of the femoral head. ④Grafting is conducive to early rehabilitation and reconstruction of femoral head necrosis.