骨水泥假体置换治疗月骨缺血性坏死的临床研究

发布时间：2018-07-01 16:41

本文选题：月骨缺血性坏死 + 骨水泥假体置换　；参考：《中国现代医学杂志》2017年01期

【摘要】：目的研究骨水泥假体治疗晚期月骨坏死的可行性和疗效。方法选取2004年1月-2015年12月该院采用骨水泥假体置换治疗晚期月骨坏死的患者10例。术中通过摘除坏死月骨,用骨水泥制作并适应性加工骨水泥月骨假体进行置换。术后随访≥1年,通过测量患者患侧手术前后及健侧手的疼痛程度、碗关节屈伸角度、握力、腕骨高度比、桡舟角及远期退变症状来评价疗效。结果所有患者术后切口皆Ⅰ期愈合,无并发症发生。术后随访1年,疗效评估以1年后复诊结果为准。末次随访时,患者视觉模拟评分为(2.0±1.15)分,较术前改善(P0.05)。腕关节屈伸角度(103±7.79)°,较术前改善(P0.05),但对比健侧仍受限。术后握力(36.8±5.96)kg,相对术前改善(P0.05),但仍较健侧低,约为健侧的(85±13)%。术后腕高比值(0.54±0.02),手术前后,术后与健侧对比,差异无有统计学意义(P0.05)。患者再无进一步的月骨塌陷和腕骨重排。术后桡舟角(58.8±6.91)°,较术前改善(P0.05)。结论骨水泥假体治疗月骨坏死能够有效终止腕骨塌陷,缓解疼痛症状,改善手部功能并停止病情进展,同时在易用性、安全性和经济上具有一定的优势。
[Abstract]:Objective to study the feasibility and efficacy of bone cement prosthesis in the treatment of late month osteonecrosis. Methods from January 2004 to December 2015, 10 patients with late monthly osteonecrosis were treated with bone cement prosthesis replacement. During the operation, the necrotic meniscus was removed, and the bone cement was used to make and process the suberenchymal bone prosthesis. The patients were followed up for more than one year. The therapeutic effect was evaluated by measuring the pain degree of the affected side and the healthy hand, the angle of flexion and extension of the bowl joint, the grip strength, the carpal height ratio, the radial scaphoid horn and the long-term degenerative symptoms. Results all the postoperative incisions healed in one stage, and no complications occurred. Follow-up 1 year after operation, the evaluation of curative effect is based on the result of follow-up after 1 year. At the last follow-up, the visual analogue score was (2.0 卤1.15), which was better than that before operation (P0.05). The flexion and extension angle of wrist joint was (103 卤7.79) 掳, which was better than that before operation (P0.05), but the contralateral side was still limited. The postoperative grip strength was (36.8 卤5.96) kg, which was better than that before operation (P0.05), but still lower than that of the healthy side (85 卤13). Postoperative carpal height ratio (0.54 卤0.02), before and after surgery, postoperative and healthy side comparison, there was no significant difference (P0.05). There was no further meniscus collapse or carpal rearrangement. After operation, the radial horn was (58.8 卤6.91) 掳, which was better than that before operation (P 0.05). Conclusion Bone cement prosthesis for the treatment of monthly osteonecrosis can effectively stop the collapse of carpal bone, relieve pain symptoms, improve hand function and stop the progression of the disease. At the same time, it has some advantages in ease of use, safety and economy.
【作者单位】：中国人民解放军第五医院骨科三病区;
【分类号】：R687.3

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