后上后前序贯复位固定C1型髋臼骨折的手术治疗  

Surgical treatment of acetabular type C1 acetabular fracture by posteroproximal-posteroanterior sequential reduction and internal fixation

作　　者：兰树华[1] 朱俊锟[1] 黄淑明[1] 叶积飞[1] 吴泉州[1] 叶方[1] 吕国强[1] 

机构地区：[1]丽水市中心医院骨科,浙江丽水323000

出　　处：《中国骨伤》2013年第6期516-520,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨C1型AO/ASIF分型髋臼骨折的手术复位技巧,分析其临床疗效。方法:自2004年8月至2012年1月,采用前后联合入路进行后上后前序贯复位、内固定治疗C1型AO/ASIF分型髋臼骨折13例,其中男8例,女5例;年龄18～64岁,平均42岁。术前经骨盆三维重建CT明确诊断分型后,于伤后5～20d手术,平均9.5d。观察手术时间、术中出血量、术后并发症情况并评价手术复位质量,末次随访时采用Matta复位标准对患者的髋关节功能进行评估。结果:手术时间为190～290min,平均240min;术中出血量1300～3000ml,平均1800ml。术后1例出现浅表感染,经加强换药于3周后愈合。根据Matta复位标准:解剖复位8例,满意复位4例,不满意复位1例。术后11例患者获得随访,平均随访时间(24.0±8.0)个月,骨折均愈合。末次随访时根据改良Meded’Aubingne和Postel临床评分:优7例,良2例,可1例,差1例。结论:对C1型AO/ASIF分型的髋臼骨折,采用后上后前的顺序进行序贯复位技术,手术流程满意,对提高手术质量有一定的帮助。Objective：To investigate the operative reduction techniques and clinical results of surgical treatment of type C1 （AO / ASIF） acetabular fracture by posteroproximal posteroanterior sequential reduction and internal fixation. Methods： From August 2004 to January 2012,13 patients with type C1 （AO / ASIF） acetabular fracture were treated by posteroproximal-posteroanterior sequential reduction and internal fixation. Of them ,8 cases were male and 5 cases were female with an average age of 42 years years old （ranged,18 to 64）. Pelvis 3-dimentional CT reconstruction were used to confirmed the classification of fracture,and the operation were performed during from 5 to 20 days with an average of 9.5 days. Operation time ,blood loss, complications and reduction were recorded and evaluated. The function of hip joint were accessed at the final follow up. Results： The operation time ranged from 190 to 290 min with an average of 240 min. The mean blood loss was 1 800 ml （ranged, 1 300 to 3 000 ml）. One case had superficial infection and healed after 3 weeks. According to Matta reduction criteria ,8 cases obtained anatomical reduction,4 cases got satisfied results and 1 cases got unsatisfied results. Eleven cases were followed up with an average of （24.0±8.0） months,and 2 cases were lost to follow-up. According to revised Mede d’Aubingne and Postel evaluation system,7 cases got excellent results,2 good,1 moderate and 1 poor. Conclusion：Posteroproximal-posteroanterior sequential reduction and internal fixation for the treatment of type C1 （AO / ASIF） acetabular fracture can achieve satisfied surgical proces and operation quality.

关 键 词：髋臼 骨折 外科手术 骨折固定术 内 

分 类 号：R683.3[医药卫生—骨科学]