复杂髋臼骨折脱位40例手术治疗及疗效分析  

Surgical therapy of displaced complex acetabular fractures and analysis of influence factors in 40 patients

作　　者：于连祥[1] 王林[1] 刘庆鹏[1] 张辉[1] 

机构地区：[1]泰山医学院附属医院骨科,泰安271000

出　　处：《中国矫形外科杂志》2012年第8期685-688,共4页Orthopedic Journal of China

摘　　要：[目的]探讨提高复杂髋臼骨折手术治疗疗效的方法和要点。[方法]总结40例复杂髋臼骨折脱位的围手术期处理及手术治疗要点和治疗效果。充分做好围手术期的各项检查和治疗,做好术前和术后的病情评估。手术中根据不同的骨折类型,分别采用不同的入路〔其中Kocher-Langenbeck入路21例,髂腹股沟入路6例,前后联合入路(髂腹股沟加K-L入路)13例〕,充分暴露骨折,准确复位,牢固内固定。[结果]平均随访时间为29个月(26～42个月)。根据Matta影像学评分,解剖复位30例,良好复位7例,差3例;优良率92.5%。局部感染2例,发生创伤性关节炎4例,异位骨化1例。[结论]充分做好髋臼骨折围手术期的治疗和处理,是手术的必要条件;正确的手术入路和术中对骨折的良好复位固定,是提高治疗疗效的关键。[ Objective ] To summarize the surgical therapy of displaced complex acetabular fractures and discuss the factors influencing results and the methods to improve effect. [ Method ] Preoperative preparation must be done. According to classifica- tion of acetabular fractures, 40 cases of complex type of acetabular fracture with dislocation were treated with open reduction and internal fixation with reconstruction plates. Kocher-Langenbeck approach was adopted in 21 cases, ilio inguinal approach in 6 cases, and anterior combined with posterior approach in 13 case. [ Result] All cases were followed up for 26 -42 months. We assessed the reduction quality with Matta radiographic grade. The function of hip joint was assessed. Thirty cases were excel- lent,7 good, 3 fair, and the rate of excellence and good results was 92.5 %. Infection was observed in 2 casee, Traumatic arthri- tis was found in 4 cases ,heterotopic ossification in 1 case. [ Conclusion] According to our experience, accurate preoperative a- nalysis of fractures,reasonable surgical approaches, high reduction quality, effective fixation are essential to good treatment of acetabular fractures.

关 键 词：髋臼骨折 围手术期 复位 内固定 疗效 

分 类 号：R687.3[医药卫生—骨科学]