复杂髋臼骨折手术疗效的影响因素分析  

Surgical treatment of complex acetabular fractures

作　　者：游景扬 王钢[2] 郑勇 陈滨[2] 任高宏[2] 陈园 范江荣 张柘 

机构地区：[1]湖北省咸宁市中心医院创伤骨科,437100 [2]南方医科大学南方医院创伤骨科

出　　处：《中国骨与关节损伤杂志》2012年第10期873-875,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨影响复杂髋臼骨折手术疗效的关键因素。方法对4l例复杂髋臼骨折行重建钢板内固定治疗，从患者年龄、受伤机制、骨折分型、合并损伤、手术时机、复位质量以及有无创伤性关节炎对临床疗效进行Postel—D＇Aubigne评分。结果按Matta复位标准：解剖复位19例，满意复位18例，不满意复位4例。41例获得38～92个月随访，平均（54．0±2．8）个月。疗效按髋关节功能Postel—D＇Aubigne评分标准：优14例，良16例，可6例，差5例。优良率73．2％。髋臼骨折解剖复位优良率89．5％（17／19），非解剖复位优良率59．1％（13／22），差异有统计学意义（x2=4．79，P=O．03）。结论早期手术，正确运用复位技巧和固定方法．妥善处理股骨头损伤或股骨颈骨折，尽可能在一个切口内采用重建钢板和拉力螺钉完成骨折固定，预防创伤性关节炎，均是提高髋臼骨折手术疗效的重要环节。Objective To explore the key factor of complex acetabular fracture. Methods All of 41 patients with the complex acetabular fractures were treated with reconstruction plate internal fixation. The clinical efficacy according to Postel- D＇Aubigne score was evaluated in terms of ages, lesion mechanism, fracture type, combined injury, surgery occasion, the quality of reduction and whether there＇re traumatic arthritis. Results According to Matta reposition standard： 19 cases were anatomical reduction, 18 eases were satisfactory reduction, 4 cases were no satisfactory reduction. All the 41 cases were followed up for 38 to 92 months, with an average of （54.0~2.8） months. According to Postel-D＇Aubigne score, the result was excellent in 14 eases, good in 16, fair in 6, and bad in 5, with the excellent and good rate of 73.2%. In the anatomic reduction group the excellent and good rate was 89.5% （17/19）, and 59.1% （13/22） in the non-anatomic reduction group. The difference was statistically significant （X2=4.79,P =0.03）. Conclusion It is very important to treat aeetabular fractures with surgery as soon as the vital signs are stable, use the reduction techniques and fixation methods correctly, make the best of the femoral head or neck fracture, complete the fracture fixation with the reconstruction plate and lag screw in the same approach and prevent traumatic arthritis.

关 键 词：复杂髋臼骨折 内固定 重建钢板 影响因素 

分 类 号：R683.3[医药卫生—骨科学]