Treatment study of traumatic avascular necrosis of the femoral head with iliac bone flap and cancellous bone graft / 中国医师进修杂志

ABSTRACT

Objective To explore the effect of iliac bone flap combined with cancellous bone graft in the treatment of traumatic avascular necrosis of the femoral head (TFHIN). Methods The patients were treated with iliac bone flap and cancellous bone graft. The operation time, intraoperative blood loss, fracture healing time, follow-up time and the postoperative complications were recorded.The degree of hip movement (flexion, external rotation, internal rotation, abduction and adduction) was recorded;the hip functions of patients with different stages were analyzed;the long-term curative effect of postoperative was analyzed. Results The operation time was (68.36 ± 6.81) min, intraoperative blood loss was(93.65 ± 10.42)ml, fracture healing time was(4.31 ± 1.25)months, follow-up time was 35-62 (48.92 ± 2.61)months, and the postoperative complication was 1.42%(3/212).The scores of hip function were significantly improved in each postoperative stage, joint flexion, external rotation, internal rotation, abduction and adduction range was significantly expanded: (94.86 ± 12.37)° vs. (118.24 ± 15.25)°, (32.07 ± 10.34)° vs. (43.64 ± 10.82)°, (28.33 ± 9.61)° vs. (33.41 ± 11.85)°, (19.44 ± 8.37)° vs. (24.36 ± 7.65)°, and the differences were statistically significant (P<0.05). At the last follow-up, the total excellent and good rate of hip function recovery was 88.74%(205/231).The stability rate of imaging was 80.09%(185/231). Conclusions In patients with TFHIN, treatment with the iliac bone flap pedicled with cancellous bone could the blood pressure of the femoral head, restore the blood supply to the damaged site, participate in the bone induction, and improve the hip movement and function,which has a good effect.