髋臼横形伴后壁骨折的手术治疗  

Surgical treatment of transverse and posterior wall fracture of acetabulum

作　　者：匡光志[1] 吴焯鹏[1] 冯华杰[1] 关万宁[1] 刘远[1] 

机构地区：[1]广东开平市中心医院骨科,529300

出　　处：《中华关节外科杂志（电子版）》2008年第2期11-13,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨髋臼横形伴后壁骨折手术治疗方法、技巧及临床效果。方法本组9例髋臼横形伴后壁骨折患者，男8例，女1例，年龄21～63岁，平均32．4岁，术前常规摄髋关节前后位、髂骨斜位、闭孔斜位片，CT平扫和三维重建，并在髋臼模型上标出骨折线的走向。采用Kocher—Lan—genbeck切口显露后柱及后壁，先复位横形骨折部份，用螺丝钉和钢丝固定，再复位后壁骨折块，用重建钢板固定。术后功能锻炼。结果本组9例均获得随访，随访时间4～48个月，平均25月。按Matta标准，在3个Judt位x线上骨折解剖复位者7例，满意复位者2例，不满意复位者0例。术后疗效评价按美国矫形外科学会制定的标准，本组优5例，良3例，可1例。结论采用螺丝钉纲丝维持和稳定已复位的横形骨折块位置，以便用重建钢板固定，手术操作简便，疗效满意。术前好的影像学资料和充分的准备对手术顺利进行非常重要。Objective To discuss the treatment strategies and clinic effect of transverse and posterior wall aectabular fractures. Methods 9 cases of transverse and posterior wall acetabular fractures who were treated operatively were followed. The age of the eases was 21 -63 years old with anverage of 32. 4 years. All the cases were diagnosed by X-ray, CT and 3-DCT . By Kocher-Langenbeck approach, the fractures were exposed, reduced and fixed with screws steel wire and restoration plate. Results 9 cases were followed up from 4 to 48 months with an average time of 25 months. They were evaluated according to Matta anatomic criteria, 7 cases anatomic reduction, 2 cases satisfied reduction. According to AAOS crite- ria for joint functions, 5 cases were excellent, 3 cases were fine, 1 cases was fair. Conclusion Keeping the reduced fracture stablized with screws, steel wire and fixed with restoration plate is a reliable and effective method for transverse and posterior wall fracture of acetabulum. Good image data and correct preoperative diagnosis are essential for getting better clinical results.

关 键 词：髋臼 骨折 内固定器 治疗 

分 类 号：R687[医药卫生—骨科学]