[1]张振南 谢利民△ 于潼.不同层面三柱结构股骨头坏死分型的差异比较研究[J].中国中医骨伤科杂志,2017,25(10):28-31,37.
　ZHANG Zhennan XIE Limin YU Tong.Comparative Study on the Differentiation of Osteonecrosis of Femoral Head at Different Sections Based on Three Pillars Structure[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(10):28-31,37.
点击复制

不同层面三柱结构股骨头坏死分型的差异比较研究()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年10期
页码:
28-31,37
栏目:
临床论著
出版日期:
2017-10-15

文章信息/Info

Title:
Comparative Study on the Differentiation of Osteonecrosis of Femoral Head at Different Sections Based on Three Pillars Structure
文章编号:
1005-0205(2017)10-0028-04
作者:
张振南1 谢利民1△ 于潼1
1中国中医科学院广安门医院(北京,100053) △通信作者 E-mail:drxlm@126.com
Author(s):
ZHANG Zhennan1 XIE Limin1 YU Tong1
1Department of Orthopedics, Guang'anmen Hospital, China Academy of Traditional Chinese Medicine,Beijing 100053,China.
关键词:
股骨头坏死;  塌陷;  预测;  CT扫描;  MRI扫描
Keywords:
Keywords: osteonecrosis of the femoral head;  subsidence;  prediction;  CT scan;  MRI scan
分类号:
R681.8
文献标志码:
A
摘要:
目的:比较冠状正中层面与最大坏死层面中日友好医院分型股骨头坏死塌陷率的差异。方法:回顾性分析2011年5月至2013年6月在中国中医科学院广安门医院骨科就诊的81例(131髋)非创伤性股骨头坏死病例,基于中日友好医院(China-Japan Friendship Hospital,CJFH)股骨头坏死分型体系,分别在冠状位正中层面及最大坏死层面对股骨头坏死分型,比较两种分型方法的股骨头坏死塌陷差异。结果:正中层面分型法中C,L1,L2及L3型分别为27髋(20.6%),46髋(35.1%),35髋(26.7%),23髋(17.6%),其塌陷率分别为48.1%(13/27),63.0%(29/46),71.4%(25/35),100%(23/23),最大层面分型法的C,L1,L2及L3型分别为13髋(9.9%),41髋(31.3%),27髋(20.6%),50髋(38.2%),其塌陷率分别为30.8%(4/13),41.5%(17/41),66.7%(18/27),100%(50/50),最大层面分型法的C,L1及L2三型塌陷率均低于正中层面,其中L1型塌陷率差异有统计学意义(χ2=4.05,P=0.04)。结论:两种层面中日友好医院分型股骨头塌陷率存在着差异,正中层面分型对股骨头坏死病变估计偏于保守,最大坏死层面分型更接近股骨头坏死实际病变情况,对于股骨头坏死塌陷预测可能更具价值。
Abstract:
Abstract Objective: To compare the differences of classification between mid-coronal coronary and largest size section to predict the collapse of osteonecrosis of femoral head(ONFH)which based on China-Japan Friendship Hospital(CJFH)classification. Methods: Eighty-one patients(131 hips)who presented with non-traumatic ONFH were treated in department of orthopedics in Guang'anmen Hospital, China Academy of Chinese Medical Science from May 2011 to June 2013. All cases were typed by CJFH classification both on the largest size section and mid-coronal coronary section. The differences between the two methods on the prediction of ONFH collapse were compared. Results: By the mid-coronal coronary section classification, C type was 27 hips(20.6%), L1 type was 46 hips(35.1%), L2 type was 35 hips(26.7%), and L3 type was 23 hips(17.6%), and the type collapse rates were 48.1%(13/27), 63%(29/46), 71.4%(25/35)and 100%(23/23)respectively. However, on the largest size section, C type was 13 hips(9.9%), L1 type was 41 hips(31.3%),L2 was 27 hips(20.6%)and L3 type was 50 hips(38.2%), with the collapse rate of 30.8%(4/13), 41.5%(17/41), 66.7%(18/27)and 100%(50/50)respectively. The collapse rates of type C, L1 and L2 in largest size section classification were lower than those in mid-coronal coronary section classification. And the collapse rate in type L1 between the two methods was statistically significant(χ2=4.05,P=0.04).Conclusion: On the two sections, the collapse rate of femoral head is different according to the classification of China-Japan Friendship Hospital.The largest size section classification can show actual lesions more exactly, it is more accurate to predict the collapse of ONFH.

参考文献/References:

[1] 赵德伟,胡永成.成人股骨头坏死诊疗标准专家共识(2012年版)[J].中华关节外科杂志:电子版,2012,6(3):479-484.
[2] Mcgrory BJ,Morrey BF,Cahalan TD,et al.Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty[J].J Bone Joint Surg Br,1995,77(6):865-869.
[3] Noble PC,Alexander JW,Lindahl LJ,et al.The anatomic basis of femoral component design[J].Clin Orthop Relat Res,1988,235:148-165.
[4] Ohzono K,Saito M,Sugano N,et al.The fate of nontraumatic avascular necrosis of the femoral head:a radiologic classification to formulate prognosis[J].Clin Orthop Relat Res,1992(277):73-78.
[5] 李子荣,刘朝晖,孙伟,等.基于三柱结构的股骨头坏死分型——中日友好医院分型[J].中华骨科杂志,2012,32(6):515-520.
[6] 李子荣.骨坏死[M].北京:人民卫生出版社,2012:148.
[7] Jwm G.ARCO committee on terminology and staging(report on the committee meeting at Santiago De Compostela)[J].ARCO Newsletter,1993,2(5):79-82.
[8] 李子荣,张念非,史振才,等.股骨头坏死塌陷的预测与治疗方法的选择[J].中华骨科杂志,2003,23(4):193-196.
[9] Kerboul M,Thomine J,Postel M,et al.The conservative surgical treatment of idiopathic aseptic necrosis of the femoral head[J].J Bone Joint Surg Br,1974,56(2):291-296.
[10] Koo KH,Kim R.Quantifying the extent of osteonecrosis of the femoral head.A new method using MRI[J].J Bone Joint Surg Br,1995,77(6):875-880.
[11] Sugano N,Takaoka K,Ohzono K,et al.Prognostication of nontraumatic avascular necrosis of the femoral head.Significance of location and size of the necrotic lesion[J].Clin Orthop Relat Res,1994,303:155-164.
[12] Hernigou P,Lambotte JC.Volumetric analysis of osteonecrosis of the femur.Anatomical correlation using MRI[J].J Bone Joint Surg Br,2001,83(5):672-675.
[13] Nishii T,Sugano N,Ohzono K,et al.Significance of lesion size and location in the prediction of collapse of osteonecrosis of the femoral head:a new three-dimensional quantification using magnetic resonance imaging[J].J Orthop Res,2002,20(1):130-136.
[14] 于潼,谢利民,吴飚,等.股骨头坏死MRI及X线片定量诊断的比较研究[J].中国中医骨伤科杂志,2013,21(4):20-22.
[15] Sugano N,Ohzono K,Masuhara K,et al.Prognostication of osteonecrosis of the femoral head in patients with systemic lupus erythematosus by magnetic resonance imaging[J].Clin Orthop Relat Res,1994,305:190-199.
[16] Min BW,Song KS,Cho CH,et al.Untreated asymptomatic hips in patients with osteonecrosis of the femoral head[J].Clin Orthop Relat Res,2008,466(5):1087-1092.
[17] Herring JA,Kim HT,Browne R.Legg-Calve-Perthes disease.Part I:Classification of radiographs with use of the modified lateral pillar and Stulberg classifications[J].J Bone Joint Surg Am,2004,86-A(10):2103-2120.
[18] Yu T,Xie L,Chu F.A Sclerotic Rim Provides Mechanical Support for the Femoral Head in Osteonecrosis[J].Orthopedics,2015,38(5):374-379.
[19] Yang JW,Koo KH,Lee MC,et al.Mechanics of femoral head osteonecrosis using three-dimensional finite element method[J].Arch Orthop Trauma Surg,2002,122(2):88-92.
[20] Cherian SF,Laorr A,Saleh KJ,et al.Quantifying the extent of femoral head involvement in osteonecrosis[J].J Bone Joint Surg Am,2003,85-A(2):309-314.

备注/Memo

备注/Memo:
基金项目:中国中医科学院广安门医院学科培育基金(2009S217)
更新日期/Last Update: 1900-01-01