Early Prediction of the Outcome in Avascular Necrosis of Femoral Head

對股骨頭缺血性壞死預後的早期預測

牛自健(Chih-Chien Nieu)；Chun-Hsiung Shih

非外傷性股骨頭缺血性壞死 ； 小範圍骨壞死 ； Nontraumatic avascular necrosis of femoral head ； minimal osteonecrosis

Journal of Orthopaedic Surgery Taiwan

10卷1期（1993 / 03 / 01）

79 - 87

英文

非外傷性股骨頭缺血性壞死乃因一些特定疾病或藥物服用或其他不明原因造成了骨頭局部缺血病變。認為會因缺血造成骨頭壞死部位的大小，所在位置以及局部骨頭再生能例情形，明顯的影響了此疾病的預後。所以對於早期的診斷病變的大小，所在位置與病理變化情形，不論是經由放射線學檢查或核磁共振攝影，可對預後的測知與治療的選擇提供非常有價值的參考。本篇即根據八年中六十四位早期股骨頭缺血性壞死的病人的放射線學檢查與臨床追蹤結果的統計分析明顯可見Type 1-C與Type-2其病變範圍超過髖臼外緣或股骨頭有早期塌陷者之預後遠比其他種類為差。

We reviewed the natural history of non-traumatic avascular necrosis of femoral head (ANFH) in 65 hips of 64 patients since Dec.1979. The mean follow-up period was 2.5 years (3 months- 9years).The modified Ohzono's radiological calssification was used to evaluate the early changes of ANFH. The results showed incidence of femroal head collapse and deterioration in type 1-B60%and 60%, type 1-c 77%and 83%, type 2 100% and 82%, type 3-A 25%and 25%, type 2-B 50% and 50%, type 4 43% and 100%. Type 1-C and type 2 showed the higher incidence than other types. The changes of femoral head were not related with the sex, age of onset and causes of the disease. The modified classification method might provide a good prediction of outcome and more exact treat-ment planning in the early stage of ANFH.