复合型髋臼骨折治疗体会  

Experience surgical management of complex acetabular fractures

作　　者：黄玉生 薛双桃 戎祖华 张俊德 艾田 

机构地区：[1]芜湖市第二人民医院骨一科,安徽芜湖241000

出　　处：《皖南医学院学报》2010年第4期279-281,共3页Journal of Wannan Medical College

摘　　要：目的:探讨手术治疗复合型髋臼骨折的临床效果。方法:根据Letournel-Judet分型,本组复合型髋臼骨折12例,其中"T"型骨折3例,横形伴后壁骨折1例,后柱伴后壁骨折4例,前柱伴后半横形骨折3例,双柱骨折1例。术中采用髂腹股沟入路5例,采用Kocher-Langenbeck入路4例,联合入路(髂腹股沟+Kocher-Langenbeck)3例。均采用克氏针、AO重建钢板和螺钉内固定。结果:本组12例均获得1～2年的随访。5例解剖复位,5例满意复位,2例复位差;关节功能优5例,良4例,可2例,差1例(优良率75%)。末次随访时,1例出现坐骨神经牵拉伤,另1例出现股骨头坏死。结论:术前准确的判断、术中良好的手术切口设计、可靠的骨折复位及术后早期髋关节功能锻炼是保证良好手术效果的关键。Objective：To evaluate the clinical outcomes of operative treatment for complex acetabular fractures. Methods：According to Letournel-Judet classification,12 cases of complex acetabular fractures fell into categories of type H（T-shaped fracture,n=3）,G（transverse and posterior wall,n=1）,F（ posterior column and wall,n=4）,I（anterior column and posterior hemitransverse,n=3） and J（complete fracture of anterior and posterior column,n=1）. Five patients received the surgery via ilioinguinal approach,4 underwent the procedure through Kocker-Lagenbach approach and 3 were treated by combination of the approaches described above. Internal fixation was dependent on Kirschner wire,AO reconstructive plate and screws. Results：Follow-up of the 12 patients in 1 to 2 years（mean 16 months） suggested that anatomical reduction was achieved in 5,satisfactory reduction in another 5 but poor in 2. Five cases were excellent,4,good,2,moderate,but 1,poor concerning joint function. In addition,the final follow-up showed that 1 case suffered from sciatic nerve injury and another 1,femoral head necrosis. Conclusion：Precise preoperative estimation,well-defined surgical incision,accurate fracture reduction and early postoperative functional exercise are the key to the treatment of complex acetabular fractures.

关 键 词：髋臼 复合型骨折 内固定 

分 类 号：R683.3[医药卫生—骨科学]