新型解剖锁定钢板在髋臼前壁骨折合并前柱骨折中的应用  

Application of a novel acetabulum anatomic locking plate in treatment of anterior wall and anterior column acetabular fractures

作　　者：黄振飞 陈开放 于凌佳[2] 孙亭方 熊泽康 郭晓东[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022 [2]北京协和医院骨科

出　　处：《中华创伤杂志》2018年第3期214-219,共6页Chinese Journal of Trauma

基　　金：国家自然科学基金（81672158,81371939）;国家重点研发计划（2016YFCll00100）

摘　　要：目的探讨新型解剖锁定钢板治疗髋臼前壁骨折合并前柱骨折的疗效。方法采用回顾性病例系列研究分析2014年3月-2016年1月收治的5例髋臼前壁骨折合并前柱骨折患者的临床资料，其中男4例，女1例；年龄25-65岁，平均41．1岁。受伤至手术时间2～5d，平均3．2d。患者均行高位髂腹股沟入路，采用新型解剖锁定钢板同时固定髋臼前壁和前柱骨折。记录手术时间、术中出血量、输血情况及骨折愈合时间；采用Matta复位标准评价骨折复位情况，采用Merle d＇Aubign6-Postel评分评价髋关节功能；观察术后并发症情况。结果5例患者获随访12-24个月，平均15．3个月。手术时间60～130min，平均96min。术中出血量100～800ml，平均230ml。术中选择性使用自体血回输，其中仅1例输异体血400ml。骨折均愈合，愈合时间为2-5个月，平均2．9个月。末次随访时根据Matta复位标准，解剖复位4例，不满意复位1例；Mede d＇Aubigne-Postel评分为15～18分，平均17．1分，其中优4例，良1例。1例患者术后出现股外侧皮神经麻痹，随访6个月麻痹症状缓解。术后无一例出现感染、股骨头缺血性坏死或创伤性关节炎等并发症。结论对于同时累及髋臼前壁及前柱的骨折，新型解剖锁定钢板可以通过单一钢板同时固定髋臼前壁及前柱，骨折复位固定满意，髋关节功能恢复良好。Objective To investigate the clinical efficacy of a novel acetabulum anatomic locking plate in the treatment of anterior wall and anterior column acetabular fracture. Methods A retrospective case series study was performed in five patients with anterior wall and anterior column acetabular fractures managed operatively using a novel acetabulum anatomic locking plate from March 2014 to January 2016. There were four males and one female, with an average age of 41.1 years （range, 25-65 years）. The mean time from injury to operation was 3.2 days （range, 2-5 days）. All patients were managed operatively using the superior ilioinguinal approach. Operation duration, intraoperative blood loss, blood transfusion, and bony union time were recorded. The image results by Matta standard were evaluated and the acetabular function after operation was assessed by modified Merle d＇Aubign6-Postel. Postoperative complications were recorded. Results All patients were followed up for average 15.3 months （range, 12-24 months）. The average operation duration was 96 minutes （range, 60- 130 minutes） and average blood loss was 230 ml （range, 100-800 ml）. Autologous blood transfusion was selectively used except for one patient with allogeneic blood transfusion of 400 ml. The mean time of bony union was 2.9 months （ range, 2-5 months ）. According to the Matta criteria, four patients attained anatomical reduction, and unsatisfactory reduction was reported in une patient. Clinical outcomes （Merle d＇Aubign^-Postel） at 12 months were 100% excellent with the average score of 17. 1 （range, 15-18）. One patient had a lateral cutaneous nerve palsy, and symptom relief was seen ＇after a follow up of 6 months. After operation, no complications such as surgical site infection, femoral head avascular necrosis, and Iraumatie m＇thritis occurred in any patient. Conclusion The novel acetabulum anatomic locking plate： can provide rigid and firm fixation for both anterior wall and anterior acetabular fractures using one

关 键 词：髋臼 髋损伤 骨折固定术 内 

分 类 号：R687.3[医药卫生—骨科学]