带血管腓骨移植与钽棒植入治疗早期股骨头坏死的临床对照(1)
[摘要] 目的 比較带血管腓骨移植术(FVFG)与钽棒植入术(TRI)治疗早期股骨头坏死(ONFH)的临床效果。方法 收集2017年1月～2018年7月在新疆医科大学附属中医医院住院的23例(24髋)早期ONFH采用FVFG术的患者资料(FVFG组)，另收集2015年1月～2016年12月收治的22例(23髋)TRI术患者资料(TRI组)，比较两组术后6个月髋关节Harris评分和X线表现指数。 结果 FVFG组2例患者因失去联系失访，最终21例患者获得随访，随访时间6～18个月，平均(12.71±2.30)个月。TRI组均获得随访，随访时间7～18个月，平均(13.31±1.33)个月。两组术后6个月髋关节Harris评分均高于术前(P < 0.05)，且FVFG组术后6个月髋关节Harris评分高于TRI组(P < 0.05)。TRI组髋关节Harris评分优良率为54.55%(12/22)，FVFG组髋关节Harris评分优良率为85.71%(18/21)，两组优良率比较，差异有统计学意义(P < 0.05)。FVFG组术后6个月X线表现指数高于术前(P < 0.05)，且FVFG组术后6个月X线表现指数高于TRI组(P < 0.05)。其中FVFG组5例有影像学进展，3例行全髋置换术;TRI组11例有影像学进展，11例行全髋置换术。两组并发症发生情况比较，差异无统计学意义(P > 0.05)。 结论 FVFG可改善早期ONFH患者髋关节功能，在防止远期股骨头塌陷方面优于TRI。
[关键词] 股骨头坏死;腓骨移植;钽棒植入
[中图分类号] R681.8 [文献标识码] A [文章编号] 1673-7210(2019)10(c)-0085-04
Clinical comparison of fibular graft with vascular pedicle and tantalum rod implantation in the treatment of early osteonecrosis of the femoral head
DENG Yingjie1 LONG Qiang2 FANG Rui1
1.The second Department of Orthopedics， Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University， Xinjiang Uygur Autonomous Region， Urumqi 830000， China; 2.the Fourth Clinical Medical College of Xinjiang Medical University， Xinjiang Uygur Autonomous Region， Urumqi 830000， China
[Abstrat] Objective To compare the clinical efficacy of fibular graft with vascular pedicle (FVFG) and tantalum rod implantation (TRI) in the treatment of early osteonecrosis of the femoral head (ONFH). Methods Data of 23 cases (24 hips) of early ONFH treated with FVFG from January 2017 to July 2018 in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University were collected (FVFG group)， in addition， data of 22 patients (23 hips) receiving TRI surgery from January 2015 to December 2016 were collected (TRI group). Harris score of hip joint and X - ray performance index were compared 6 months after operation. Results In FVFG group， 2 patients were lost to follow-up because of losing contact. In the end， 21 patients were followed up for 6 to 18 months， with an average of (12.71±2.30)months. All patients in TRI group were followed up for 7 to 18 months， with an average of (13.31±1.33)months. The Harris score of hip joint of the two groups at 6 months after operation were higher than those before operation (P < 0.05)，and the Harris score of hip joint in FVFG group was higher than that in TRI group (P < 0.05). The excellent and good rate of Harris score of hip joint in TRI group was 54.55% (12/22)， while that in FVFG group was 85.71% (18/21)， and there was statistically significant difference in the excellent and good rate between the two groups (P < 0.05). The X-ray performance index of the two groups at 6 months after operation were higher than those before operation (P < 0.05)， and the X-ray performance index of FVFG group at 6 months after operation was better than that of TRI group (P < 0.05). In FVFG group， 5 cases had imaging progress， 3 cases had total hip replacement， 11 cases had imaging progress in TRI group and 11 cases had total hip replacement. There was no statistically significant difference in the incidence of complications between the two groups (P > 0.05). Conclusion FVFG can improve hip function in early ONFH patients and is superior to TRI in preventing long-term femoral head collapse., http://www.100md.com(邓迎杰 龙强 方锐)
[关键词] 股骨头坏死;腓骨移植;钽棒植入
[中图分类号] R681.8 [文献标识码] A [文章编号] 1673-7210(2019)10(c)-0085-04
Clinical comparison of fibular graft with vascular pedicle and tantalum rod implantation in the treatment of early osteonecrosis of the femoral head
DENG Yingjie1 LONG Qiang2 FANG Rui1
1.The second Department of Orthopedics， Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University， Xinjiang Uygur Autonomous Region， Urumqi 830000， China; 2.the Fourth Clinical Medical College of Xinjiang Medical University， Xinjiang Uygur Autonomous Region， Urumqi 830000， China
[Abstrat] Objective To compare the clinical efficacy of fibular graft with vascular pedicle (FVFG) and tantalum rod implantation (TRI) in the treatment of early osteonecrosis of the femoral head (ONFH). Methods Data of 23 cases (24 hips) of early ONFH treated with FVFG from January 2017 to July 2018 in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University were collected (FVFG group)， in addition， data of 22 patients (23 hips) receiving TRI surgery from January 2015 to December 2016 were collected (TRI group). Harris score of hip joint and X - ray performance index were compared 6 months after operation. Results In FVFG group， 2 patients were lost to follow-up because of losing contact. In the end， 21 patients were followed up for 6 to 18 months， with an average of (12.71±2.30)months. All patients in TRI group were followed up for 7 to 18 months， with an average of (13.31±1.33)months. The Harris score of hip joint of the two groups at 6 months after operation were higher than those before operation (P < 0.05)，and the Harris score of hip joint in FVFG group was higher than that in TRI group (P < 0.05). The excellent and good rate of Harris score of hip joint in TRI group was 54.55% (12/22)， while that in FVFG group was 85.71% (18/21)， and there was statistically significant difference in the excellent and good rate between the two groups (P < 0.05). The X-ray performance index of the two groups at 6 months after operation were higher than those before operation (P < 0.05)， and the X-ray performance index of FVFG group at 6 months after operation was better than that of TRI group (P < 0.05). In FVFG group， 5 cases had imaging progress， 3 cases had total hip replacement， 11 cases had imaging progress in TRI group and 11 cases had total hip replacement. There was no statistically significant difference in the incidence of complications between the two groups (P > 0.05). Conclusion FVFG can improve hip function in early ONFH patients and is superior to TRI in preventing long-term femoral head collapse., http://www.100md.com(邓迎杰 龙强 方锐)