腹直肌外侧切口联合K-L入路治疗复杂髋臼骨折  

Treatment of complex acetabular fractures treated with lateral rectus abdominis incision combined with K-L approach

作　　者：谢易[1] 龚泰芳[1] 李彬彬[1] 肖亮 XIE Yi;GONG Tai-fang;LI Bin-bin;XIAO Liang(Department of Joint Bone,Taihe Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]湖北医药学院附属太和医院关节骨科,湖北十堰442000

出　　处：《创伤外科杂志》2018年第11期845-847,共3页Journal of Traumatic Surgery

摘　　要：目的探讨腹直肌外侧入路联合K-L入路治疗髋臼双柱骨折的临床疗效。方法 2013年1月—2017年6月湖北医药学院附属太和医院关节骨科收治复杂髋臼骨折的病例共28例,其中男性17例,女性11例;年龄17～60岁,平均42. 6岁。均采用腹直肌外侧入路联合K-L入路手术方式,记录术中出血量、手术时间、伤口感染情况。结果所有病例均获得10～18个月临床随访,平均13. 5个月,均达到临床愈合。术中出血量480～800mL,平均620. 5mL。根据Matta标准评估骨折复位情况,解剖复位20例,良好复位6例,较差复位2例。根据改良的Merle D'Aubigne and Postel系统评价髋关节功能:优19例,良7例,差2例。无伤口感染,无股神经、坐骨神经、髂血管损伤,无异位骨化或下肢深静脉血栓形成等并发症。结论采用腹直肌外侧入路联合K-L入路治疗髋臼双柱骨折,能够清晰地显露髋臼前后柱,能保证有效地复位和固定,符合微创理念,临床效果确切。Objective To explore the clinical effect of lateral approach of rectus abdominis combined with K-L approach in the treatment of acetabular double column fractures. Methods From Jan. 2013 to Jun. 2017,a total of 28 cases of complex acetabular fractures were treated in our department,including 17 cases of male and 11 cases of female. Their age ranged from 17 to 60 years,with an average of 42.6 years. All the cases were performed by the lateral approach of rectus abdominis combined with K-L approach. The intraoperative blood loss,operation time,and wound infection were recorded to analyze the postoperative effect. Results All cases were followed up for 10-18 months,with an average of 13.5 months. All patients achieved bone healing. Intraoperative blood loss was 480-800 mL,with an average of 620.5 mL. According to the Matta standard,anatomical reduction was achieved in 20 cases,good reduction in 6 cases and poor reduction in 2 cases. According to the systematic evaluation of improved Merle D Aubigne and Postel,19 cases were excellent,7 cases were good,and 2 cases were poor. There was no wound infection,no injuries in femoral nerve,sciatic nerve,and iliac blood vessel,no obvious ossification or deep venous thrombosis of lower extremity. Conclusion The use of lateral approach of rectus abdominis combined with K-L approach for the treatment of acetabular double column fractures can clearly expose the anterior and posterior acetabular column,which can guarantee effective reduction and fixation.

关 键 词：髋臼骨折 入路 内固定 

分 类 号：R683.3[医药卫生—骨科学]