合并后壁骨折的复杂性髋臼骨折手术疗效分析  

Analysis of Operative Treatment for Complex Acetabular Fractures Involving the Posterior Wall

作　　者：孟纬 潘昊鹏 吕庆生[1] 朱伟[2] 

机构地区：[1]天津市滨海新区汉沽医院,天津300480 [2]北京积水潭医院手外科,天津100035

出　　处：《实用骨科杂志》2015年第3期207-209,279,共4页Journal of Practical Orthopaedics

摘　　要：目的对手术治疗合并后壁骨折的复合髋臼骨折进行回顾性研究,评价其治疗效果。方法随访2003年8月至2013年8月采用切开复位内固定治疗的59例患者,其中横断伴后壁骨折41例,后柱伴后壁骨折18例。58例患者采用Kocher-Langenbeck入路,1例患者采用联合入路（K-L入路联合髂腹股沟入路）。采用改良的Merle d＇Aubigné和Postel评分系统评价临床效果,用Matta放射学标准评价影像学结果。结果 59例患者平均随访4.3年（2.0~8.8年）。最终影像学结果：优23例（39%）,良22例（37%）,可10例（17%）,差4例（7%）,优良率76%。最终临床效果：优21例（36%）,良26例（44%）,可9例（15%）,差3例（5%）,优良率80%。结论对合并后壁骨折的复合髋臼骨折,切开复位内固定治疗可以获得满意效果。根据本组患者的治疗经验,对这类骨折推选双钢板固定。Objective To evaluate the results of patients with operatively treated complex acetabular fractures involving the posterior wall retrospectively. Methods We reviewed fifty-nine patients who undurent open reduction and internal fixation of an unilateral fracture of the acetabulum between August 2003 to August 2013. Forty-one patients were diagnosed as transverse plus posterior wall fracture and eighteen patients were diagnosed as posterior column plus posterior wall fracture. The functional outcome was evaluated using a modification of the clinical grading system developed by Merled＇ Aubigné and Postel.The radiographs were graded according to the criteria described by Matta. Results Fifty-nine patients were followed for a mean of 4. 3 years（ range,2. 0 ~ 8. 8 years）. The radiographic result was excellent in twenty-three patients（ 39%）,good in twenty-two（ 37%）,fair in ten（ 17%）,and poor in four（ 7%）. The clinical outcome at the time of final follow-up was graded as excellent in twenty-one patients（ 36%）,good in twenty-six（ 44%）,fair in nine（ 15%）,and poor in three（ 5%）. Conclusion Anatomic reduction and stable internal fixation is the key in obtaining satisfactory results in the management of these fractures. According to our result,we recommend to fix these fractures using double plates.

关 键 词：骨折 内固定 复合髋臼骨折 后壁 

分 类 号：R687.3[医药卫生—骨科学]