严重移位髋臼骨折手术治疗.docVIP

严重移位髋臼骨折手术治疗【摘要】 目的 总结严重移位髋臼骨折手术内固定的治疗经验。方法 对21例有移位的髋臼骨折手术治疗后的病例进行临床总结与分析。根据Letournel-Judet分型:横形骨折7例,横形加后壁骨折9例,双柱骨折3例,T形骨折2例。分别采用Kocher-Langenbeck入路、髂腹股沟入路及前后联合入路进行切开复位内固定。结果 21例患者平均随访21.5个月。根据美国矫形外科研究院评价标准评价临床结果,本组优8例(38.1%),良10例(47.6%),可3例(14.3%),优良率为85.7%。其中2例发生股骨头坏死,2例骨性关节炎,1例出现深部感染,无内固定物折断。结论 正确分析骨折类型,选择恰当的手术入路,尤其是前后联合入路可提高严重移位髋臼骨折手术治疗效果。 【关键词】 髋臼骨折;移位;手术入路;内固定 The Severe Displaced Acetabular Fracture Fixation Treatment ZHANG Wen-cong.Department of Orthopaedics,ShiHua Hospital in MaoMing City,GuangDong 525000,China 【Abstract】 Objective To summarize the severe displaced acetabular fracture fixation treatment experience.Methods To have 21 cases of displaced acetabular fractures after surgical treatment of clinical cases of summary and analysis.According to Letoumel-Judet classification:seven cases of transverse fracture,transverse plus posterior wall fracture of nine cases,three cases of double-column fractures.T-shaped fracture in 2 cases.Using Kocher-Langenbeck approach,ilioinguinal approach,and before and after the combined approach to open reduction and internal fixation.Results 21 cases of patients with mean follow-up of 21.5 months.According to American Academy of Orthopedic Surgery Clinical evaluation of the results of the evaluation criteria,the group of eight cases of excellent(38.1%),good in 10 cases(47.6%),three cases can be(14.3%),excellent and good rate was 85.7%.Of which two cases of osteonecrosis of the femoral head occurred,two cases of osteoarthritis,one patienthad deep infection,no broken internal fixator.Conclusion Analysis of fracture type,select the appropriate surgical approach,especially before and after the combined approach can improve severe displaced acetabular fracture treatment. 【Key words】Acetabular fracture;Displacement;Surgical approach;Internal fixati 伴随高能量创伤的增多,骨盆骨折中髋臼骨折的发生也越来越多,为了获得较好的治疗效果,现国内外学者多主张手术治疗。髋臼骨折属关节内骨折,要求解剖复位、坚强内固定、早期功能恢复。笔者自2004年1月至2009年8月,对发生移位的髋臼骨折经恰当手术入路进行内固定治疗,取得较好的疗效,现报告如下。 1 资料与方法 1.1 一