复杂型髋臼骨折的手术治疗  

Operation treatment on complex acetabular fractures

作　　者：潘志军[1] 郑强[1] 洪华兴[1] 陈欣[1] 徐刚[1] 

机构地区：[1]浙江大学医学院附属第二医院骨科,杭州310009

出　　处：《中华急诊医学杂志》2005年第2期108-111,共4页Chinese Journal of Emergency Medicine

摘　　要：目的　探讨复杂型髋臼骨折的手术治疗方法及其并发症。方法　对 5 9例复杂型髋臼骨折进行回顾分析 ,其中后壁后柱联合骨折 17例。横行和后壁联合骨折 11例 ,T形骨折 16例 ,前柱骨折伴半横行后柱骨折 8例 ,完全双柱骨折 7例 ,采用的手术入路分别为Kocher-Langenbeck入路 (K L入路 )、髂腹股沟入路、前后联合入路、扩大髂股入路、三叉形扩展型线入路。手术入路的选择以骨折类型为基础。结果　经 5～ 38个月随访 ,平均为 16 5个月。根据Matta评分 ,髋关节功能优异 13例 ,良好 30例 ,一般 13例 ,差 3例。 15例发生不同程度的异位骨化 ,发生股骨头坏死 7例 ,创伤性骨关节炎 12例。结论　复杂型髋臼骨折术前正确分析骨折类型 ,选择合适的手术入路 。Objective To investigate operation treatment of complex acetabular fractures and relative complications.Methods Fifty-nine cases with complex acetabular fractures were retrospectively analyzed.The cases were classified according to Letournel-Judet classification:17 cases with posterior column and wall fracture,11 cases with transverse and posterior wall fracture, 16 cases with T_shaped fracture,8 cases with anterior and hemitransverse fracture,and 7 cases with both-column fractures.Kocher-langebeck approach,ilioinguinal approach,triradiate approach,extended-iliofemoral approach or anterior combined posterior approach were adopted according to different fractures.Results All patients were followed up for an average period of 16.5 months(5～38 months).According to Matta's evalution,13 cases were excellent,30 cases were good,13 cases were fair,and 3 cases were poor.Avascular necrosis of the femoral head was found in 7 cases,heterotopic ossification in 15 cases,and traumatic arthritis in 12 cases.No patients died.Conclusion Correct classification of fracture before operation,appropriate surgical approach and timely operation are key to treat complex acetabular fractures.

关 键 词：髋臼骨折 手术入路 复杂型 骨折类型 后壁 手术治疗 并发症 K-L 发生 选择 

分 类 号：R687.3[医药卫生—骨科学]