手术治疗髋臼合并同侧股骨干骨折的临床研究  

Clinical Study of the Treatment of Lpsilateral Acetabular Fracture and Femoral Fracture

作　　者：王开明[1] 杨德顺[1] 廖亮[1] 秦骥[1] 张庆[1] 

机构地区：[1]安徽省蚌埠市第三人民医院骨科,安徽蚌埠233000

出　　处：《实用骨科杂志》2009年第2期88-90,共3页Journal of Practical Orthopaedics

摘　　要：目的总结髋臼合并同侧股骨干骨折的手术方法和治疗效果。方法从2003～2006年共手术治疗12例。股骨干骨折根据AO的Müller分类法,A1型3例,A2型2例,A3型3例,B2型3例,C2型1例。髋臼骨折按AO的Letour-nel-Judet分型,A1型2例,A2型1例,B型5例,C型4例。根据不同骨折类型,分别采用不同手术入路进行骨折复位内固定。结果12例患者平均随访15.8个月,根据Matta影像学评分,解剖复位7例,满意复位3例,不满意复位2例。根据D′Aubigné和Postel功能评分法,优6例(50.00%),良2例(16.67%),可3例(25.00%)),差1例(8.33%)。根据Epstein影像学标准评价,优7例,良2例,可2例,差1例。发生股骨头坏死合并创伤性关节炎1例(8.33%),异位骨化1例(8.33%)。无手术死亡、感染及骨折不愈合发生。结论把握合适的手术时机,准确的评估骨折类型,选择正确的手术入路,配合术中灵活的处理,是提高疗效的关键。Objective To improve the effect of operative treatment of ipsilateral acetabular fractures and femoral fractures by analyzing the clinical experiences in the treatment of the fractures. Methods In this series, 12 ipsilateral acetabular fractures and femoral fractures were reviewed. Femoral fractures were classified according to Muller classification. Of the 12 cases,fractures of A1 type were seen in 3 cases,A2 type in 2 cases,A3 type in 3 cases,B2 type in 3 cases,and C2 type in 1 case. Acetabular fractures were classified according to Letournel-Judet classification. In those cases,fractures of A1 type were seen in 2 cases,A2 type in 1 ease,B type in 5 cases,and C type in 4 cases. Different approach and treatment were adopted in those cases according to the type of fractures. Results All the cases were followed up for average 15. 8 months. According to criteria of Matta radiographic grade, there were 7 eases with anatomic reduction, 3 with satisfactory reduction,and 2 with unsatisfactory reduction. Based on the D＇Aubign6 and Postel clinical grading system, 6（50% ） cases showed excellent results, 2（16.67%） cases good, 3（25 % ） cases fair and 1 （8. 33%） cases poor. According to criteria of Epstein radiographic grade, 7 cases showed excellent results, 2 cases good, 2 cases fair and 1 case poor. Avascular necrosis of the femoral head and traumatic arthritis were found in 1 case （8.33%） ,heterotopic ossification was found in 1 case （8.33%）. No death ,infection or nonunion were found. Conclusion Operation on time ,exact judgment of fracture type, reasonable surgical approaches and treatment in operation are essential to good results of ipsilateral acetabular fractures and femoral fractures.

关 键 词：髋臼 股骨 骨折 外科 手术 治疗结果 

分 类 号：R683.42[医药卫生—骨科学]