| Object: To explore the clinical efficacy of the treatment of middle and advanced Osteonecrosis of the Femoral Head in patients with advanced Osteonecrosis of the Femoral Head by using hip surgery and dislocation head and neck fenestration and postoperative use of Shanjia Huoxue Bushen Recipe,and further accumulate experience for hip protection of femoral head necrosis.Methods: From January 2016 to March 2018,I was admitted to the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine in the ARCOIII stage with a degree of collapse of >2 mm in ONFH patients.A total of 15 16 hips,aged 17 to 46 years,averaged 32.76 years,including males 12 Example 13 hips,3 women and 3 hips.According to the cause classification:5 hips were hormonal ONFH,10 hips were alcoholic ONFH,and 1 hip was idiopathic ONFH;classified according to the degree of collapse:10 hips with a collapse degree of 2mm to 4 mm and 6 hips with a collapse degree of > 4 mm;According to CJFH classification(according to necrotic position):C-type 3 hips,L1 type 6 hips,L2 type 4 hips,L3 type 3 hips;16 hips are kidney deficiency and blood stasis type;patients all underwent surgical dislocation of the head and neck opening window Bone grafting,postoperative treatment of stagnation of blood and kidney.All cases were followed up for more than12 months.The Harris score and imaging stability of the postoperative and follow-up were recorded in detail,and compared with preoperative,the excellent rate and imaging stability rate were calculated.Results:(1)All patients underwent clinical follow-up from December to June(mean 17.4 months).The total Harris score at the last follow-up was increased from 62.26±5.67 to 74.37±6.46,and the difference was statistically significant(P <0.05).Among them,excellent 0 hips,good 7hips,5 hips,and 4 hips,the total excellent and good rate was 43.75%,and the total excellent and good rate before surgery was 12.5%.The final follow-up Harris score of patients with a collapse degree of 2 mm to 4mm increased from 72.16±2.41 points before surgery to 79.83±3.62 points,the difference was statistically significant(P<0.05),and the final follow-up Harris score was determined by patients with a collapse degree >4 mm.The preoperative rate of 57.65±4.13 was increased to61.14±6.18,the difference was not statistically significant(P>0.05),the preoperative excellent rate of patients with collapse degree of 2mm ~4mm and collapse degree>4mm was 20.0%,0%respectively.The excellent follow-up rate was 70.0% and 0%,respectively.The final follow-up Harris score of type C patients in CJFH was increased from 76.13±6.81 to83.64±8.67,the difference was statistically significant(P<0.05),and the final follow-up Harris score of L1 patients was 71.19±8.33 before surgery.The score was increased to 79.61±5.22,the difference was statistically significant(P<0.05).The last follow-up Harris score of L2 and L3 patients increased from 64.77±2.11 points and 53.51±4.15 points to 68.05±7.19 points and 58.72±3.46 points.The difference was not statistically significant(P>0.05).The preoperative excellent rate of patients with type C and L1 was 66.7% and 0%,respectively.The excellent and good rate of last follow-up were 100% and 66.7%,respectively.L2 and L3 patients The excellent and good rate of preoperative and last follow-up were 0%.(2)All patients with the last follow-up of the DR double-hip positive frog showed that 6 hips(37.5%)collapsed to some extent,5 hips(31.25%)collapsed without aggravation,and the remaining 5 hips(31.25%)continued to collapse,but no cause Severe necrosis must be performed in patients with total hip arthroplasty.Conclusion:Hip surgical dislocation head and neck fenestration combined with Shanjia Huoxue Bushen Recipe can promote ONFH repair.The clinical effect is clear in the near future.It is more suitable for the collapse degree of ARCOIII stage is 2mm~4mm and the type is CJFH type C type and L1 type ONFH patients. |
PDF Full Text Request