Clinical Analysis Of The Treatment Of Femoral Head Necrosis By Using Pure Magnesium Screw To Reconstruct Femoral Head

Objective:To investigate the clinical effect of biodegradable pure magnesium screw fixation of large lateral transverse branch trochanter bone flap for reconstruction of femoral head for the treatment of femoral head necrosis.Methods:Ten ONFH patients(10 hips)admitted to our hospital from January 2015 to December 2016 were retrospectively analyzed.The transverse femoral trochanter flap was repaired by transversal lateralization of femoral circumflex artery.Among them,male 4,and 6 females;mean age(33.6 years ± 5.1 years),22 years old and 44 years old;left limb in 7 cases and right side in 3 cases;ARCO stage IIIc 6 cases and ARCO stage IV 4 cases.The follow-up period was 12 months and was divided into 6 stages(preoperative,intraoperative,postoperative day,3 months postoperatively,6 months postoperatively and 12 months postoperatively),and were evaluated in three aspects:(1)General conditions Including operation time,blood loss,laboratory tests(serum magnesium,calcium,phosphorus and erythrocyte sedimentation rate,CRP),postoperative joint replacement rate,adverse reactions Etc.);(2): Imaging evaluation: X-ray observation of magnesium nail degradation and observation of graft fixation reliability,the shape of the femoral head is changed;CT measurement 12 months after the screw around the bone CT value,to determine the magnesium(3)Clinical evaluation: Harris hip score(HHS)and visual analogue scale(VAS).The above results were statistically analyzed to determine the curative effect.Results:The activities of the hip joint in 10 patients were significantly increased and the pain relief was significantly relieved.The rate of excellent and good follow-up was 70%.The results of imaging examination showed that the shape of femoral head was good,the position of graft flap was good,,Screw fixation is reliable;serum magnesium,calcium,phosphorus levels no significant fluctuations compared with the preoperative,ESR,CRP in addition to the day after surgery larger fluctuations,the rest of the stages were no significant differences compared with preoperative.The results of SPSS 22 software showed that Harris score of hip joint was significantly increased at the last follow-up(P <0.05)and VAS pain score was significantly decreased(P <0.05).CT scan results show that the diameter of biodegradable magnesium screws gradually reduced,bone around the screw growth is good,no osteolytic phenomenon.During the follow-up period,none of the 10 patients experienced serious complications such as displaced bone flap displacement,perioperative infection,deep venous thrombosis of the lower extremities,and pulmonary embolism.None of the patients underwent total hip arthroplasty.Conclusion:The pure magnesium screw fixation bone graft for reconstruction of femoral head short-term clinical curative effect is reliable,compared with the traditional surgical procedures,the operation is simple,the operation time is short,and pure magnesium screw can be degraded without secondary surgery.