Freierg 病的研究治疗进展.docVIP

Freiberg病的研究治疗进展 郭建斌 王树森 韩一生Δ 【摘 要】 目的: 总结和探讨 Freiberg 病的病因、诊断、治疗方面的进展，了解 Freiberg 病治疗的现状及发展趋势。使广大医务工作者及患者对本病有一个全面的认识。 方法：查阅近年来针对Freiberg 病的相关文献，对 Freiberg 病的病因、分期、诊断、治疗等方面进行全面的回顾和综合性的分析。 结果：Freiberg 病是一种少见的骨软骨病，发病的原因是多方面的，近年来研究表明其发病的原因与累积劳损、拇外翻畸形、服用糖皮质激素等有关。根据患者的 Smillie 分期，给出相应的治疗，早期保守治疗有很好的效果，后期往往考虑手术。 结论：Freiberg 病是指发生在跖骨二次骨化中心的缺血性坏死，本病起病隐匿，早期难以诊断，所以对高危人群定期的复查，做到早期诊断早期治疗是我们最求的目标。 【关键词】 Freiberg 病 跖骨头坏死 病因 诊断 手术选择 人工关节置换术 RESEARCH AND TREATMENT PROGRESS OF FREIBERG DISEASE/GUO Jianbin，WANG Shusen，HAN Yisheng. Department of Orthopedics, Xijing Hospital, The Fourth Military University, Xi’an, 710032,China. Corresponding author:HAN Yisheng,E-mail: drhanys@fmmu.edu.cn 【Abstract】 Objective To summarize and discuss the etiology, staging, clinical and imaging manifestation, and treatment progress of Freiberg disease to provide more information for clinical application. Methods The related domestic and abroad original literature in recent years about Freiberg disease was reviewed extensively. The etiology, staging, clinical and imaging manifestation, and treatment progress was synthetic analyzed. Results The etiology of Freiberg disease is closely related to the anatomy factor, work condition, Hallux valgus deformity, a large number of taking glucocorticoid hormone also lead the disease. The imaging presentation was related to staging, the clinical presentation was local pain and swelling around the metatarsophalangeal joints, and last restricted joint motion. According to the different phases, conservative therapy was effective at early stage. While surgical treatments such as osteotomy, autologous osteochondral plug transplantation, arthroscopic interpositional arthroplasty, Swanson double-stem silicone implant arthroplasty were used in late stage. Conclusion Although many methods can achieved good effect, we should chose the appropriate one on the basis of patients. While the good prevent, the early diagnose and treatment is very important. Key words: Freiber