CN108294848A - 一种股骨头坏死症的治疗方法 - Google Patents

一种股骨头坏死症的治疗方法 Download PDF

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CN108294848A
CN108294848A CN201810210766.0A CN201810210766A CN108294848A CN 108294848 A CN108294848 A CN 108294848A CN 201810210766 A CN201810210766 A CN 201810210766A CN 108294848 A CN108294848 A CN 108294848A
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赵凤朝
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Abstract

一种股骨头坏死症的治疗方法，涉及医学技术领域，设置带有锥度的圆柱形假体和刮除空腔，使两者形状契合，且所述假体一端插入刮除空腔，另一端的端面为经过抛光处理的抛光面，抛光面适应前述被刮除的股骨头面的弧度，圆柱形主体采用多孔金属棒。本方法假体和骨头融合度高，不易脱落，术后使用摩擦小、耐用，对患者而言负担轻，舒适度高，不易复发。

Description

一种股骨头坏死症的治疗方法
技术领域
本发明涉及医学技术领域，具体涉及一种股骨头坏死症的治疗方法。
背景技术
股骨头坏死是指由于各种原因导致的股骨头缺血，即由于血液供应的中断或大幅度减少，造成局部血供障碍，引起骨细胞缺血性坏死、塌陷的一种严重并发症。又分为创伤性股骨头坏死和非创伤性股骨头坏死，创伤性股骨头坏死多由于股骨颈部位发生骨折，造成股骨头血运中断，即使骨折愈合，由于股骨头骨骼缺血时间较长，也会导致骨骼发生坏死、塌陷。非创伤性股骨头坏死常见的病因包括：大量使用激素、长期酗酒等，导致股骨头内血液循环改变，影响股骨头骨骼营养状态，导致骨骼坏死、塌陷。
现有的股骨头坏死治疗方法包括以下几种：
1、前期消炎，后期中医治疗。
该种治疗模式仅适用于轻微可逆转的股骨头坏死症状，且疗效并不稳定，目前临床适用面窄，且成功率低，此外，消炎时会使用大量的抗生素，容易对患者治疗后产生其他副作用。
2、股骨头刮除手术。
该种治疗模式适用范围广泛，但是现有的股骨头刮除手术精确度差，治疗过程全凭术者的经验，导致常常出现假体与刮除空腔不匹配，容易滑脱或与骨头不匹配，磨损严重，此外，植入后的假体与骨头还不易长合，这些原因都会导致术后依旧让患者感到痛苦不适，使患者长期承受身体和心理折磨，苦不堪言的问题。
发明内容
本发明所要解决的技术问题在于克服现有的技术缺陷，提供一种股骨头坏死症的治疗方法，易于操作、操作精度高、假体植入效果好、植入后骨头长合度好。
本发明所要解决的技术问题采用以下的技术方案来实现：一种股骨头坏死症的治疗方法，包括以下步骤：(1)、通过术前的磁共振和常规CT扫描，确定患者股骨头坏死区域，计算出待刮除的部位的形状、被刮除的股骨头面的弧度；(2)、根据步骤1测量计算得到的数据，制作带锥度的圆柱形假体，所述锥度的范围为1-5°；所述假体的一端插入股骨头，另一端的端面为经过抛光处理的抛光面，抛光面适应前述被刮除的股骨头面的弧度，圆柱形主体采用多孔金属棒；(3)、刮除步骤1中确定的坏死区域部分的坏死病灶，并用截骨导板将坏死病灶及其基底部制备成为与假体形状契合的刮除空腔；(4)、将步骤2制作好的假体嵌入步骤3中制备的刮除空腔内。
假体和刮除空腔的形状不在采用现有的垂直设置的圆柱形，而采用有锥度的圆柱形，能够有效防止假体滑脱。此外，术前通过现代的检查手段，确定假体和刮除空腔的形状，使得两者安装贴合度高，更加不易脱落；尤其是假体的两段式制作，表面为抛光面，与骨面弧度契合，使得术后使用的磨损被降低到最小，让患者术后不会因磨损度高，感觉关节酸涩难耐，而主体采用的多孔金属棒均为类似于钽棒的结构，方便骨长入达到牢固固定，后期骨头于假体的融合度好，不易再次复发。
具体的，所述多孔金属棒采用多孔金属钽棒，所述假体的抛光面采用钴铬钼合金面。钴铬钼合金非常耐磨，多孔金属钽棒与骨头的长合度很好。
进一步，还包括步骤5：检测假体与刮除空腔的嵌入状态，当假体尺寸与刮除空腔不适应，贴合处存在间隙时，配备骨水泥注入并填满间隙处。骨水泥可以消除制作误差，使得假体与骨头的粘结牢靠。
具体的，步骤2中所述的锥度采用2°。
本发明的有益效果为：提供一种股骨头坏死症的治疗方法，易于操作、操作精度高、假体植入效果好、植入后骨头长合度好，减轻了股骨头坏死症患者的痛苦。
附图说明
图1是本发明检测的股骨头坏死区域形状示意图。
图2是本发明刮除空腔形状示意图。
图3是本发明假体形状示意图。
具体实施方式：
为了使本发明实现的技术手段、创作特征、达成目的与功效易于明白了解，下面结合具体实施例以及患者病例，进一步阐述本发明。
如图1-3所示，一种股骨头坏死症的治疗方法，包括以下步骤：
(1)、通过术前的磁共振和常规CT扫描，确定患者股骨头坏死区域1，并计算出待刮除的部位的形状、被刮除的股骨头面的弧度；
(2)、根据步骤1测量计算得到的数据，制作带锥度的圆柱形假体3，锥度为2°，圆柱体的截面为1.5cm的圆形；所述假体3的一端向下插入刮除空腔，另一端的端面为经过抛光处理的抛光面，抛光面适应前述被刮除的股骨头面的弧度，抛光面采用钴铬钼合金面，耐磨，圆柱形主体采用多孔金属钽棒，方便骨长入达到牢固固定的目的。
(3)、刮除步骤1中确定的坏死区域部分的坏死病灶，并用截骨导板将坏死病灶及其基底部制备成为与假体3形状契合的刮除空腔2；
(4)、将步骤2制作好的假体3嵌入步骤3中制备的刮除空腔内。
(5)、检测假体3与刮除空腔2的嵌入状态，当刮除空腔2制作时出现轻微失误，导致假体3尺寸与刮除空腔2不适应，贴合处存在间隙时，配备骨水泥注入并填满间隙处，达到粘结牢靠的目的。
本方法假体和骨头融合度高，不易脱落，术后使用摩擦小、耐用，对患者而言负担轻，舒适度高，不易复发。

Claims (4)

1.一种股骨头坏死症的治疗方法，其特征在于，包括以下步骤：
(1)、通过术前的磁共振和常规CT扫描，确定患者股骨头坏死区域，计算出待刮除的部位的形状、被刮除的股骨头面的弧度；
(2)、根据步骤1测量计算得到的数据，制作带锥度的圆柱形假体，所述锥度的范围为1-5°；所述假体的一端插入股骨头，另一端的端面为经过抛光处理的抛光面，抛光面适应前述被刮除的股骨头面的弧度，圆柱形主体采用多孔金属棒；
(3)、刮除步骤1中确定的坏死区域部分的坏死病灶，并用截骨导板将坏死病灶及其基底部制备成为与假体形状契合的刮除空腔；
(4)、将步骤2制作好的假体嵌入步骤3中制备的刮除空腔内。
2.根据权利要求1所述的一种股骨头坏死症的治疗方法，其特征在于，所述多孔金属棒采用多孔金属钽棒，所述假体的抛光面采用钴铬钼合金面。
3.根据权利要求1所述的一种股骨头坏死症的治疗方法，其特征在于，还包括步骤5：检测假体与刮除空腔的嵌入状态，当假体尺寸与刮除空腔不适应，贴合处存在间隙时，配备骨水泥注入并填满间隙处。
4.根据权利要求1所述的一种股骨头坏死症的治疗方法，其特征在于，步骤2中所述的锥度采用2°。
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