Comparison of clinical efficacy of modified quadrat femoral bone flap and traditional quadrat femoral bone flap in the treatment of osteonecrosis of the femoral head in young adults

doi:10.3877/cma.j.issn.2096-0263.2024.03.007

Abstract

Abstract:

Objective

To investigate the clinical effect of the modified quadrat femoral bone flap and the traditional quadrat femoral bone flap.

Methods

According to the inclusion and exclusion criteria, data of 78 patients who received hip preservation surgery for femoral head necrosis from 920th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from January 2019 to July 2020 were collected and divided into the improved quadrate femoral bone flap group and the traditional quadrate femoral bone flap group, with 38 cases in each group, operation time, incision length, Hb reduction, VAS score 36 months after operation, Harris score of hip joint, hip joint motion and complications, and survival rate of femoral head were compared between the two groups. To evaluate the clinical effect of the two surgical methods.

Results

All patients successfully completed the operation and were followed up for (39.5±3.2) months. No complications such as wound infection and deep vein thrombosis occurred. The average incision length and Hb decline of the improved group were (10.7±0.9) cm and (10.6±1.1) g/L, which were both decreased compared with the traditional group (13.5±0.7) cm and (12.1±1.1) g/L, P<0.05, and the difference was statistically significant. The Harris score (86.7±4.5) and ROM (311.5±15.0) in the improved group were significantly improved than those in the traditional group (82.7±5.4) and 294.4±20.8) 36 months after surgery (P<0.05), and the difference was statistically significant. There were no significant differences in operation time and VAS scores between the two groups. The superior rate of the improved group was 94.7% and 89.5%, and the survival rate of the improved group was higher than the traditional group.

Conclusion

The modified quadrate femoral bone flap can effectively preserve the posterior superior supporting band artery of the femoral head. The clinical effect of the modified quadrate femoral bone flap is better than that of the traditional quadrate femoral bone flap in the treatment of femoral head necrosis in young adults.

Key words: Osteonecrosis of the femoral head, Modified quadrat femoral bone flap, Hip joint, Digital subtraction angiography

Luqiao Pu, Chuan Li, Baochuang Qi, Pengfei Bu, Xingbo Cai, Yan Bai, Huan Luo, Yongqing Xu. Comparison of clinical efficacy of modified quadrat femoral bone flap and traditional quadrat femoral bone flap in the treatment of osteonecrosis of the femoral head in young adults[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(03): 165-170.

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References 21

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组别	例数	性别（例）		年龄（岁，±s）	ARCO分期（例）		病因（例）		Harris评分（分，±s）	VAS评分（分，±s）	ROM（°，±s）
组别	例数	男	女	年龄（岁，±s）	Ⅱ期	Ⅲ期	酒精	激素	Harris评分（分，±s）	VAS评分（分，±s）	ROM（°，±s）
传统组	38	30	8	33.9±5.6	27	11	16	22	72.9±2.6	4.5±0.6	183.8±11.1
改良组	38	32	6	35.1±7.2	28	10	18	20	72.7±2.7	4.3±0.6	180.9±10.8
统计值		0.35		-0.54	0.66		0.21		0.29	1.39	1.14
P值		0.554		0.58	0.798		0.645		0.768	0.168	0.255

组别	例数	性别（例）		年龄（岁，±s）	ARCO分期（例）		病因（例）		Harris评分（分，±s）	VAS评分（分，±s）	ROM（°，±s）
组别	例数	男	女	年龄（岁，±s）	Ⅱ期	Ⅲ期	酒精	激素	Harris评分（分，±s）	VAS评分（分，±s）	ROM（°，±s）
传统组	38	30	8	33.9±5.6	27	11	16	22	72.9±2.6	4.5±0.6	183.8±11.1
改良组	38	32	6	35.1±7.2	28	10	18	20	72.7±2.7	4.3±0.6	180.9±10.8
统计值		0.35		-0.54	0.66		0.21		0.29	1.39	1.14
P值		0.554		0.58	0.798		0.645		0.768	0.168	0.255

组别	例数	切口长度（cm）	手术时间（min）	Hb下降（g/L）	术后36个月评分
组别	例数	切口长度（cm）	手术时间（min）	Hb下降（g/L）	Harris评分	VAS评分	ROM（°）
传统组	38	13.5±0.7	50.9±4.7	12.1±1.1	82.7±5.4	1.8±1.1	294.4±20.8
改良组	38	10.7±0.9	51.7±4.6	10.6±1.1	86.7±4.5	1.5±0.7	311.5±15.0
t值		14.60	-0.72	5.59	-3.50	1.45	-4.09
P值		0.000	0.469	0.000	0.001	0.151	0.000

组别	例数	切口长度（cm）	手术时间（min）	Hb下降（g/L）	术后36个月评分
组别	例数	切口长度（cm）	手术时间（min）	Hb下降（g/L）	Harris评分	VAS评分	ROM（°）
传统组	38	13.5±0.7	50.9±4.7	12.1±1.1	82.7±5.4	1.8±1.1	294.4±20.8
改良组	38	10.7±0.9	51.7±4.6	10.6±1.1	86.7±4.5	1.5±0.7	311.5±15.0
t值		14.60	-0.72	5.59	-3.50	1.45	-4.09
P值		0.000	0.469	0.000	0.001	0.151	0.000

组别	例数	优（%）	良（%）	总优良率（%）	可（%）	差（%）
传统组	38	5（13.1%）	29（76.3%）	34（89.5%）	2（5.1%）	2（5.1%）
改良组	38	6（15.7%）	30（78.9%）	36（94.7%）	1（2.6%）	1（2.6%）
检验统计量		0.01	0.00	0.00
P值		0.972	0.987	0.991

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