Selection of placement position of support points for early and mid-term mechanical repair of femoral head necrosis
10.12200/j.issn.1003-0034.20221199
- VernacularTitle:股骨头坏死早中期力学修复支撑点放置位置选择
- Author:
Shuai-Lei LI
1
;
Xiao-Bo CHEN
;
Xiao-Lan SONG
;
Yang LI
;
Yong-Qiang SUN
Author Information
1. 河南省洛阳正骨医院河南省骨科医院郑州院区,河南 郑州 450008
- Keywords:
Femoral head necrosis;
Biomechanics;
Ccollapse;
Repair
- From:
China Journal of Orthopaedics and Traumatology
2024;37(8):808-813
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of the placement of the main mechanical support points in the early and middle stages of mechanical repair of femoral head necrosis in preventing collapse of the femoral head.Methods A retrospective analysis was performed for 17 cases 22 hips of non-traumatic femoral head necrosis in the early and middle stages from June 2018 to June 2019,including 14 males 18 hips and 3 females 4 hips,aged 34 to 47 years old.Among them,6 cases were hormonal,8 were alcoholic and 3 were idiopathic.According to China-Japan Friendship Hospital(CJFH)classification,9 hip were type L1,8 were L2,5 were L3.All cases were given dead bone scraping,autologous iliac granules pressed bone graft-ing,and allogeneic fibula column support treatment.After surgery,Sanqi Jiegu Pill(三 七 接 骨 丸)was administered orally for 3 months.X-rays of both hips were performed after surgery and follow-up,and the clinical efficacy was evaluated by hip Harris score before and after surgery.Results All cases were followed up for 24 to 38 months.The Harris score of 22 hips increased from 58 to 77 preoperative to 68 to 94 at the final follow-up.At the final follow-up,3 hips were excellent,1 1 hips were good,3 hips were acceptable,5 hips were poor.Two hips of L2 type progressed to ARCO Ⅲ B stage and continued to be observed,2 hips of L2 type and 2 hips of L3 type progressed to ARCO Ⅳ stage,and received total hip replacement,and 1 hip infection at 3 months after surgery was given a cement spacer.Conclusion Based on CJFH classification,collapse can be predicted to a cer-tain extent according to the area,volume,location and human biological characteristics of osteonecrosis,and the main mechan-ical support points are found on this basis to prevent collapse.
