髋臼后壁骨折手术治疗的疗效分析  

Analysis of operative treatment for posterior wall fractures of the acetabulum

作　　者：杨明辉[1] 吴新宝[1] 王满宜[1] 朱仕文[1] 曹奇勇[1] 吴宏华[1] 程小光[2] 赵英威[2] 王昕晖[2] 

机构地区：[1]北京大学医学部第四临床医学院,北京积水潭医院创伤骨科,100035 [2]北京大学医学部第四临床医学院,北京积水潭医院放射科,100035

出　　处：《中华创伤杂志》2007年第7期481-485,共5页Chinese Journal of Trauma

基　　金：北京市“十百千”卫生人才工程2005年资助项目

摘　　要：目的通过对手术治疗髋臼后壁骨折的回顾性研究，分析影响其疗效的因素。方法1993年8月-2004年8月手术治疗髋臼后壁骨折74例，用改良的Merle d’Aubigné和Postel评分系统评价临床效果，用Matta放射学标准评价影像学结果。结果74例患者平均随访4．3年（2—10．6年）。最终影像学结果：优34例（46％），良28例（38％），可7例（9％），差5例（7％），优良率84％。最终临床效果：优18例（24％），良43例（58％），可7例（9％），差6例（8％），优良率82％。临床效果与影像学结果存在相关性。结论骨折解剖复位牢固固定是获得满意结果的基础。骨折复位差、合并股骨头骨折、严重异位骨化和股骨头坏死是影响治疗效果的主要因素。Objective To evaluate the factors affecting surgical results via a retrospective study of operative treatment for posterior wall fractures of the acetabulum. Methods A total of 74 patients with posterior wall fractures of the acetabulum treated with open reduction and internal fixation from August 1993 to August 2004 were employed to evaluate clinical results by using a modified clinical grading system developed by Merle d＇Aubigné and Postel. In the meantime, the radiographs were graded according to the criteria described by Matta. Results All patients were followed for mean 4.3 years （2-10.6 years）. The radiographic result was excellent in 34 patients （46%）, good in 28 （38%）, fair in 7 （9%） and poor in 5 （7%） , with excellence rate of 84%. The clinical outcome at the time of final follow-up was graded as excellent in 18 patients （24%） , good in 43 （58%） , fair in 7 （9%） and poor in 6 （ 8% ） , with excellence rate of 82%. There was a strong correlation between the clinical outcome and the final radiographic grade. Conclusions Anatomic reduction and stable internal fixation are key to obtaining satisfactory results in the management of such fractures. Poor fracture reduction, combined fracture of femoral head, severe beterotopic ossification and osteonecrosis are main risk factors affecting clinical results.

关 键 词：髋臼 骨折固定术 内 后壁 

分 类 号：R686[医药卫生—骨科学]