前路铁板结合方形区螺钉内固定治疗涉及方形区的髋臼骨折  

Quadrilateral plate fractures of the acetabulum treated by internal fixation with reconstruction titanium plate combined with trans-plate quadrilateral screws via the ilioinguinal approach

作　　者：蔡贤华[1] 刘曦明[1] 汪国栋[1] 徐峰[1] 王华松[1] 李世梁[2] 黄大伟[2] 徐洲发[2] 

机构地区：[1]广州军区武汉总医院骨科,武汉:430070 [2]湖北中医药大学研究生学院

出　　处：《中华创伤骨科杂志》2013年第2期102-106,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨前路铁板结合方形区鲸钉内固定治疗涉及方形民的做臼付折的疗效。方 法 2005年In至20门年5月共收治52例涉及方形区的愤臼骨折患者，其中36例获得随访，男21例，女15例;年龄21 - 59岁，平均43.5岁。筒＇忻按Letournel分型：双柱伺如15例，极形骨折4例，前性伴后半横形骨析8例，r形骨折9例。所有患者均采用儒腹股沟入路，复位后行重边铁板及经铁板3 -5 i攸皮质件蝶钉（方形区蝶钉）部分经骨表团内固定。术后应用Malia放射学标准评估骨折复位质量，末 次随访时采用改良Merle d＇Aubigne和Postel＇iIl分标准评定髓关节功能。结果 36例忠吁吁术后~x12 -72个月（平均41. 7个月）随访。术后＇丹折u位质iJ：恢Matta放射学标准评定：解削复位19例，良好 复位12例，不满忘飞复位5例，复位优良率为86.1%。所有患者旬＇折均获l临床愈合，愈合时间为2-4个月，平均3个月。末次随访时采用改良Merle d＇Aubign岳和P叫el W分标准评定俄关节功能：优16例，良13例.IlJ 5例.＆2例，优良率为80.6%。本组患者功能优良率与骨折复位质itt呈明显正相关（ r = 0.513， P =0. 001）。元一例j血者友生JJ形区蝶钉松脱、断裂。结论 Tiu＇路铁板结合方形区虫害{钉内回应 可靠，无进入髋关节腔之虞，是治疗以前往损伤为主的双柱骨折、向前移位的横形忏折、部分前柱合并后半横j彤＇自折＇及部分T形骨折的有效方法之一。Objective To explore the clinical efficacy of internal fixat.ion using reconstruction tita- niulll plate combined with trans-plate quadrilateral screws in treatment of quadrilateral plate fractures of the acetabulum via the ilioinguinal approach. Methods Of the 52 quadrilateral plate fractures of the ac-etahululTl which had been treated between January 2005 and May 20川, 36 cases were followed up. They were 21 males and 15 females, with an average age of 43.5 years （from 21 to 59 years）. By Letournel＇s classifi- cation, there were 15 double-column fractures, d transverse ones, 8 anterior column plus posterior he- mi-transverse ones and 9 T-shaped ones. All the fractures were treated with internal fixation using recon- struction titanium plate combined with 3 to 5 trans-plate cortical screws （so-called quadrilateral screws） via the ilioinguinal approach after the fracture reduction. In some, fixation was conducted via the bone surface. The quality of reduction was evaluated using the Matta＇s radiologic scoring system whilst the hip functional recovery using the modified Merle d＇ Aubign6 and Postel scoring system. Results The duration of follow-up was 12 to 72 months （average, 41.7 months） . Nineteen patients achieved anatomical reduction, 12 patients func- tional reduction and 5 patients dissatisfactory reduction, giving an excellent and good rate of 86. 1%. All the patients achieved fracture healing after 2 to 4 months （average, 3 months）. In terms of functional recovery, 16 patients were rated as excellent, 13 as good, 5 as acceptable and 2 as poor, giving an excellent and good rate of 80.6%. The rate of excellent and good recovery was positively related to the quality of the fracture reduction （ r = 0.513, P = 0. 001 ）. No loosening or breaking of screws happened at the follow-ups. Conclusion In- ternal fixation using reconstruction titanium plate combined with trans-plate quadrilateral screws via ilioinguinal approach is an effective choice for treatment of double-column fractures

关 键 词：榄臼 骨折 骨折固定术 内 骨板 

分 类 号：R687.3[医药卫生—骨科学]