移位髋臼骨折手术治疗技巧探讨  

Surgical technique in treatment 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]汕头市中心医院、中山大学附属汕头医院骨科,515031

出　　处：《中华创伤杂志》2011年第10期924-928,共5页Chinese Journal of Trauma

摘　　要：目的探讨移位髋臼骨折手术治疗的方法和技巧。方法自2005年8月至2009年6月，共开展移位髋臼骨折手术66例。根据骨折分型，选择前入路髂腹股沟入路12例，后入路Kocher—Langenbeck入路30例，前后联合入路22例，“Y”形入路2例，采用重建钢板内固定。结果本组患者平均手术时间3．4h（1．5～6．5h），平均出血量550ml（350～l200m1），平均随访时间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Merled’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。结论jE确的骨折分型诊断，合适的手术入路选择，各种复位方法与固定技巧的熟练运用，合理的围术期处理是取得手术成功的关键因素。Objective To discuss the method and surgical technique in treatment of the displaced acetabular fracture. Methods The study involved 66 patients with displaced aeetabnlar fracture treated operatively with reconstruction plates from August 2005 to June 2009. Based on the fracture typing, the surgical techniques including anterior ilioinguinal, posterior Kocher-Langenbeck, combined ilioinguinal and Kocher-Langenbeck and ＂Y＂ shaped approach were performed in 12, 30, 22 and 2 patients, respectively. Results The operation time was mean 3.4 hours （ 1.5-6.5 hours） , with mean blood loss of 550 ml （range, 350-1 200 ml）. All patients were tbllowed up for average 29 months （range, 12- 46 months）. According to Matta evaluation standard, the reduction of acetabular fracture was anatomical in 34 patients, imperfect in 25 and unsatisfactory in seven. According to the modified Merled＇ Aubigne and Postel clinical evaluation standard, the clinical outcome was graded as excellent in 23 patients, good in 29, fair in eight and poor in six. Conclusion The factors key to successful operation include correct fracture classification, good approach anatomy, proficient technique of reduction and fixation, and reasonable perioperation measures.

关 键 词：髋臼 骨折固定术 内 手术入路 

分 类 号：R687.3[医药卫生—骨科学]