移位髋臼骨折手术并发症的防治策略  

Measures of prevention and treatment in the operative complications of displaced acetabular fracture

作　　者：张育锋[1] 钟志刚[1] 邱雪立[1] 林本丹[1] 陈树鑫[1] 

机构地区：[1]广东省汕头市中心医院中山大学附属汕头医院,515031

出　　处：《中国矫形外科杂志》2010年第14期1171-1174,共4页Orthopedic Journal of China

基　　金：2008年度汕头市重点科技计划项目(编号:汕府科2008-85-6)

摘　　要：[目的]探讨移位髋臼骨折手术治疗常见并发症及其防治措施。[方法]自2005年8月～2009年月6月,共开展移位髋臼骨折手术66例。手术入路以前方的髂腹股沟入路和后方的Kocher-Langenbeck入路,或者前后联合入路为主。总结患者功能结果并统计常见并发症发生率。[结果]平均随访29个月(12～46个月)。按照Matta标准,解剖复位34例,良好复位25例,不满意复位7例。根据改良的Merle d'Aubigne和Postel的髋臼骨折临床结果评分标准,优23例,良29例,可8例,差6例。手术并发症坐骨神经损伤2例,创伤性关节炎14例,异位骨化10例,股骨头缺血坏死2例。无感染和死亡病例。[结论]正确的骨折分型,合适的手术时机,良好的入路解剖,熟练的手术技巧与合理的围术期处理是减少移位髋臼骨折手术并发症的重要因素。[Objective]To discuss the common complications and the methods of prevention and treatment in the operation of displaced acetabular fracture.[Method]Sixty-six cases with displaced aceuabular fracture were treated operatively from August 2005 to June 2009.Approach included anterior ilioinguinal approach,posterior Kocher-Langenbeck approach,or combined ilioinguinal and Kocher-Langenbeck approach.The functional results and complications were analyzed.[Result]All cases were followed up for an average of 29 months（12-46 months）.According to the Matta evaluation,the anatomical reduction of acetabular fracture were in 34 cases,perfect in 25,and unsatisfactory in 7.According to the modified Merle d＇ Aubigne and Postel clinical evaluation standard,the clinical outcome was graded as being excellent in 23 cases,good in 29,fair in 8,poor in 6.Sciatic nerve injury after operation were noted in 2 hips,osteoarthritis in 14,heterotopic ossification in 10,and avascular necrosis of femoral head in 2.No infection and death were founded in this group.[Conclusion]The important factors to decrease the operative complications of acetabular fracture include correct fracture classification,suitable operative time,good operative approach,proficient technique of reduction and fixation and reasonable perioperative measures.

关 键 词：髋臼 骨折 外科手术 并发症 

分 类 号：R687.3[医药卫生—骨科学]