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中华关节外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (02) : 255 -260. doi: 10.3877/cma.j.issn.1674-134X.2022.02.021

微创关节技术

髋关节外科脱位治疗股骨头坏死的手术体会
邢丹1, 林剑浩1,(), 高嘉翔1   
  1. 1. 100044 北京大学人民医院骨关节科
  • 收稿日期:2020-10-10 出版日期:2022-04-01
  • 通信作者: 林剑浩
  • 基金资助:
    北京大学人民医院研究与发展基金(RDX2020-02,RDY2019-11)

Surgical hip dislocation in treatment of femoral head necrosis

Dan Xing1, Jianhao Lin1(), Jiadan Gao1   

  • Received:2020-10-10 Published:2022-04-01
  • Corresponding author: Jianhao Lin
引用本文:

邢丹, 林剑浩, 高嘉翔. 髋关节外科脱位治疗股骨头坏死的手术体会[J]. 中华关节外科杂志(电子版), 2022, 16(02): 255-260.

Dan Xing, Jianhao Lin, Jiadan Gao. Surgical hip dislocation in treatment of femoral head necrosis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(02): 255-260.

图1 以旋股内侧动脉为核心的股骨头血供系统
图2 患者体位的摆放及固定
图3 切开阔筋膜和髂胫束后显露肌肉和血管神经组织
图4 截骨线的位置和周围肌肉
图5 截骨块的位置及肌肉附着
图6 翻开截骨块显露下方结构
图7 Z字型切开关节囊
图8 屈曲、外旋髋关节半脱位股骨头
图9 剪断股骨头圆韧带
图10 全脱位股骨头充分显露髋臼及股骨头结构
图11 头颈交界处开窗、清除坏死骨及植骨
图12 术前及术后X线。图A术前双髋正位像见双侧股骨头坏死(ARCO三期),右侧股骨头外侧见囊性变,股骨头略塌陷;图B术前骨盆蛙式位像见头臼关系良好;图C术后双髋正位像见右髋关节内4枚螺钉内固定,股骨头内原囊性变区密度较前增高;图D右髋关节斜位像见右髋关节内4枚螺钉内固定
[1]
Sevitt S, Thompson RG. The distribution and anstomoses of arteries supplying the head and neck of the femur [J]. J Bone Joint Surg Br, 1965, 47: 560-573.
[2]
Trueta J. The normal vascular anatomy of the femoral head in adult man. 1953[J]. Clin Orthop Relat Res, 1997, (334): 6-14.
[3]
Gautier E, Ganz K, Krugel N, et al. Anatomy of the medial femoral circumflex artery and its surgical implications[J]. J Bone Joint Surg Br, 2000, 82B(5): 679-683.
[4]
Ganz R, Gill TJ, Gautier E, et al. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis[J]. J Bone Joint Surg Br, 2001, 83(8): 1119-1124.
[5]
Guindani N, Eberhardt O, Wirth T, et al. Surgical dislocation for pediatric and adolescent hip deformity: clinical and radiographical results at 3 years follow-up[J]. Arch Orthop Trauma Surg, 2017, 137(4): 471-479.
[6]
Liu Q, He HB, Zeng H, et al. Modified trapdoor procedures by surgical dislocation approach to treat chondroblastoma of the femoral head[J]. Bone Joint J, 2019, 101-B(6): 732-738.
[7]
Zhang D, Chen L, Wang G. Hip arthroscopy versus open surgical dislocation for femoroacetabular impingement: A systematic review and meta-analysis[J/OL]. Medicine (Baltimore), 2016, 95(41): e5122. DOI: 10.1097/MD.0000000000005122.
[8]
Probe R. Surgical dislocation of the hip in the treatment of complex osteochondral injury to the femoral head[J]. J Orthop Trauma, 2016, 30 Suppl 2: S17-S18.
[9]
Yao C, Yi N, Shen J, et al. Clinical reports of surgical dislocation of the hip with sequestrum clearance and impacting bone graft for grade IIIA-IIIB aseptic necrosis of femoral head (ANFH) patients[J]. Oncotarget, 2017, 8(30): 50084-50090.
[10]
Gavaskar AS, Tummala NC. Ganz surgical dislocation of the hip is a safe technique for operative treatment of pipkin fractures. results of a prospective trial[J]. J Orthop Trauma, 2015, 29(12): 544-548.
[11]
Espinosa N, Beck M, Rothenfluh D, et al. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. Surgical technique[J]. J Bone Joint Surg Am, 2007, 89 Suppl 2 Pt.1(1): 36-53.
[12]
何伟.如何把握股骨头坏死患者的保髋治疗时机[J].中国骨与关节杂志20165(2):82-86.
[13]
Gibson A. Posterior exposure of the hip joint[J]. J Bone Joint Surg Br, 1950, 32-B(2): 183-186.
[14]
Tosounidis TH, Giannoudis VP, Kanakaris NK, et al. The Kocher-Langenbeck approach: state of the art[J/OL]. JBJS Essent Surg Tech, 2018, 8(2): e18. DOI: 10.2106/JBJS.ST.16.00102.
[15]
Nork SE, Schär M, Pfander G, et al. Anatomic considerations for the choice of surgical approach for hip resurfacing arthroplasty[J]. Orthop Clin North Am, 2005, 36(2): 163-170, viii.
[16]
Yue JJ, Wilber JH, Lipuma JP, et al. Posterior hip dislocations: a cadaveric angiographic study[J]. J Orthop Trauma, 1996, 10(7): 447-454.
[17]
Schlonsky J, Miller PR. Traumatic hip dislocations in children[J]. J Bone Joint Surg Am, 1973, 55(5): 1057-1063.
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