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[目的]探讨经皮头颈开窗人工骨支撑植骨术治疗早期股骨头坏死(塌陷前期)的近期临床疗效.[方法] 2010年8月～2012年1月,本组共46例(51髋)患者接受经皮头颈开窗人工骨支撑植骨术治疗早期股骨头坏死(ACROⅡ期),其中男31例,女15例,平均年龄36.4岁,29例为酒精性ONFH,17例为激素性ONFH.术后第1、2、3、6个月、1年及以后每年门诊定期随访、X线片复查,依据Harris髋关节评分及优良率评估疗效.[结果]经过至少2年(25～52个月,平均38.6个月)随访,共44例(49髋)得到末次随访(失访率4.08％).Harris评分由术前(73.50±6.81)分提高到末次随访时的(87.30±9.62)分,优良率由术前32.65％提高至末次随访时的87.75％,其中ACROⅡA期由37.50％提高到100％,ⅡB期由34.78％提高到91.30％,ⅡC期由27.77％提高到77.77％,手术前后优良率的差异具有统计学意义(P＜0.05).该组共有8.16％ (4/49)的患者最终行全髋关节置换术,其中ACROⅡA期0例,ⅡB期1例,ⅡC期3例;影像学显示共有14.29％ (7/49)的患者发生影像学进展,其中ACROⅡA期0例,ⅡB3例,ⅡC期4例.[结论]经皮头颈开窗人工骨支撑植骨术治疗早期股骨头坏死的近期疗效满意,具有操作简单、手术创伤小、恢复快及并发症少等优点,但中远期临床效果尚待进一步观察.“,”[Objective] To explore outcome of artificial bone impaction grafting through a percutaneous fenestration for treatment of osteonecrosis of femoral head (ONFH) at early stage.[Methods] From August 2010 to January 2012,46 patients (51 hips),31 males and 15 females with an average of 36.4 years,were diagnosed as ONFH (ACRO stage Ⅱ) including alcohol-induced ONFH in 29 patients and steroid ONFH in 17 patients.All patients were surgically treated with artificial bone impaction grafting through a percutaneous femoral neck fenestration.The patients were regularly followed up and evaluated with Harris score postoperatively.[Results] Forty-four patients (49 hips) completed the final follow-up at least 2 years (25-52 months,mean 38.6 months).Harris score increased from (73.5±6.81) points preoperatively to (87.3±9.62) points at the latest follow up.Correspondingly,overall excellent and good rate increased from 32.7％ to 87.8％.Based on ACRO staging,excellent and good rate increased from 37.5％ to 100％ in patients of ARCO Ⅱ A,from 34.8％ to 91.3％ in the ARCO Ⅱ B,while from 27.8％ to 77.8％ in the ARCO Ⅱ C.The differences of Harris scores and excellent and good rate between preand post-operation were statistical significant (P ＜ 0.05).The rate of clinical failure was 8.2％ (4/49 hips),including 0 hip in ARCO Ⅱ A,1 hip in ARCO Ⅱ B and 3 hips in ARCO Ⅱ C.The rate of radiographic progression was 14.3％ (7/49),including 0 hip in ARCO Ⅱ A,3 hips in ARCO Ⅱ B and 4 hips in ARCO Ⅱ C.[Conclusion] Artificial bone impaction grafting through percutaneous fenestration for the treatment of femoral head osteonecrosis at early stage achieves good short-term outcomes,with advantages of simplification of surgical manipulation,minimal invasion,rapid recovery and less complication.However,long-term clinical results still need by further follow-up.