股骨头坏死属于骨科中的慢性疑难病症,尤其是晚期的股骨头坏死患者,会出现股骨头塌陷,此时只能采取全髋关节置换手术。因此必须警惕早期症状和加强早期检查,以免错过了最佳治疗时期。1、警惕早期症状(1)疼痛:通常为针刺样、钝痛或酸痛,常向后侧和膝内侧放射,并伴有麻木感,活动后疼痛加重。
这天,医院的骨科专家做了一个更换双侧股骨头关节的手术。当专家看见患者的股骨头时,不由得倒吸了一口凉气:双侧股骨头坏死已经全部变形。这是一个年仅28岁的林姓青年,前来就诊时已有11年的酒龄。几个月前,在家人的搀扶下,一脸痛苦地走进了骨科诊室。
今天和大家来聊聊“股骨头坏死”1病因~股骨头坏死发病原因是供应股骨头的血供发生了中断,引起的股骨头的坏死。其病因很多,一般分为两大类:一类是创伤性因素,比如股骨颈骨折、股骨头骨折、髋关节脱位等。另一类是非创伤性的,比如长期应用激素、长期的酗酒等。
45岁曹某为餐饮业老板,为了生意时常需交际应酬,近期因髋部疼痛至诊所检查,透过X片检查无异状,但髋部仍疼痛不已,来院透过核磁共振检查,确诊为股骨头坏死,所幸初期发现,透过“股骨头髓芯减压术”治疗,才得以保留原生关节。
股骨头缺血性坏死开始可以没有任何症状,患者逐渐感觉髋部隐隐作痛,髋部是上半身和大腿连接的地方,许多患者理解为臀部,股骨头坏死的确会引起臀部疼痛,但更多的出现在腹股沟,还有大腿前内侧,以及膝关节内上方的位置。
三年前,15岁的花季少女小美因确诊系统性红斑狼疮,需要服用激素类药物,服药一年后,她感觉到自己右侧髋关节处经常疼痛,已经影响了正常走路,在绍兴当地医院查双侧髋关节核磁共振后,确诊双侧股骨头无菌性坏死,因年龄较小,症状较轻微,所以小美采取了保守治疗。
Conservativetreatments for aseptic osteonecrosis of the femoral head have their ancestor inthe core decompression of the femoral neck, recommended by Ficat. Due toinconsistent results, this treatment has been optimized by either vascularizedfibular grafting, or by injecting autologous stem cells into the necrotic zone.The French promoters have published long-term results, showing efficacy in theearly stages of the disease, where the femoral head has not yet lost itssphericity. Over the last 10years, comparative studies, sometimes randomized,opposing them to simple core decompression, have been published bynon-promoters, confirming the possibility of stabilization or even regressionof necrosis area. But these techniques are not easy to implement. Cell therapyrequires treatment of marrow samples by centrifugation to obtain a pellet witha high concentration of haematopoietic cells. The now proven long-term efficacyas well as the safety of this technique make it the method of choice fortreating young patients detected at the sub-radiological stage by MRI.Unfortunately, many are seen late with detached cephalic cartilage or collapsedfemoral head and have no other option than total hip arthroplasty. Thistechnique is very reliable. With alumina ceramics, results of more than 20yearsshow the absence of wear and osteolysis, although other complications such asinstability or periprosthetic fractures may occur in these young and activepatients.
他说,他这个大腿根已经疼了,好长时间了有好几年,但是一直也都没怎么管它平常疼的时候就吃一点止疼药休息一下,然后就能缓解,如果再疼了就再吃药,最近这一年发现吃药也不太管用了,而且疼得越来越厉害, 都没有办法走路了,于是到医院来看一下,究竟是怎么回事?
髋关节骨性关节炎误诊为股骨头坏死几率很高,两者的症状和体征相似,影像学上的检查又难以辨别,故应该多几个方面进行鉴别诊断。示例1:髋关节骨性关节炎示例1:髋关节骨性关节炎示例1:髋关节骨性关节炎①病因不同。