经改良Stoppa入路治疗骨盆髋臼骨折的临床体会  

Clinical analysis of modified Stoppa approach in treatment of pelvic and acetabular fractures

作　　者：倪明[1] 沈燕国[1] 胡晓亮[1] 秦惠敏[1] 丁菊红[1] 邱永敏[1] 

机构地区：[1]上海市浦东新区人民医院骨科,201200

出　　处：《中国骨与关节损伤杂志》2013年第2期101-103,共3页Chinese Journal of Bone and Joint Injury

基　　金：浦东新区优秀青年医学人才培养计划(PWRq2012-15)

摘　　要：目的探讨采用改良Stoppa入路治疗骨盆、髋臼骨折的手术方法和初步体会。方法采用改良Stoppa入路治疗16例骨盆、髋臼骨折。术前均摄骨盆正、斜位X线片和三维CT检查,体外模拟骨折复位与固定。术中采用仰卧位或漂浮体位,通过改良Stoppa入路或联合髂窝入路与K-L入路,直视下复位骨折,透视证实复位满意后采用重建钢板内固定。结果切口长度6.5-12 cm,手术时间40-160 min,术中失血50-1 000 ml。术后X线片显示骨盆、髋臼骨折复位满意。16例获随访6～12个月。疗效根据Matta功能标准评定:优9例,良6例。无坐骨神经损伤、深静脉血栓和骨折再移位发生。结论改良Stoppa入路联合髂窝或K-L入路治疗骨盆、髋臼骨折暴露充分、操作简单、效果可靠,尤其适用于双侧耻骨骨折和四边形面内移的髋臼骨折。Objective To introduce the preliminary experience of using modified Stoppa approach in treatment of pelvic and acetabular fractures. Methods Modified Stoppa approach was performed on 16 eases. All patients underwent pelvic radiography and three-dimensional CT imaging reconstruction. Surgical simulation was performed on pelvic model before operation. Fractures were exposed and fixed through modified Stoppa approach combined with iliac or K-L approach under the guidance of C-arm. Results The incision length was 6.5-12 era,the operation time and blood loss were 40~160 minutes and 50-1 000 ml respectively.The reduction of the pelvic and acetabular fractures was excellent according to X-ray. All patients were followed up for 6-12 months, the treatment effect：excellent in 9 eases,good in 6 eases. There were no operative complications. Condusion Modified Stoppa approach combined with iliac or K-L approach is suitable for pelvic and aeetabular fractures,especially bilateral pubic ramus and acetabular fractures with displacement of quadrilateral plate ,with advantages of adequate exposure, simple operation and good clinical results.

关 键 词：骨盆骨折 髋臼骨折 内固定 改良STOPPA入路 

分 类 号：R683.3[医药卫生—骨科学]