髋关节骨折脱位合并坐骨神经损伤的临床特点及疗效分析  

The clinical characteristics of fracture-dislocation of the hip complicated with sciatic nerve injury and the analysis of the result of treatment

作　　者：刘卓[1] 刘磊[1] 吕智[1] 

机构地区：[1]山西医科大学第二附属医院,山西太原030001

出　　处：《中国骨伤》2002年第9期524-525,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的　回顾性分析髋关节骨折脱位合并坐骨神经损伤的特点及治疗效果。方法　对 4 8例髋关节骨折脱位合并坐骨神经损伤患者的手术及保守治疗后进行随访 ,平均随访 2年 6个月。结果4 8例中 ,39例行手术治疗 ,其中 32例伤后 3周内进行 ,7例伤后 3周～ 3个月内进行。 9例行非手术治疗。根据MCRR标准 ,伤后 3周内手术的 32例中 ,优 18例 ,良 8例 ,差 5例 ,劣 1例。伤后 3周～ 3个月内手术的 7例中 ,优 1例 ,良 3例 ,差 1例 ,劣 2例。 9例非手术治疗者 ,优 6例 ,良 3例。结论　髋关节骨折脱位合并坐骨神经损伤的患者应及早积极手术治疗 ,尽快恢复髋关节解剖结构 ,尽快解除坐骨神经的压迫 ,对髋关节创伤性关节炎的发生发展及坐骨神经功能的恢复有密切关系。Objective To improve the effect of treatment of fracture dislocation of the hip complicated with the sciatic nerve injury by analyzing its characteristics and result of treatment Methods 48 cases of fracture-dislocation of the hip complicated with sciatic nerve injury were reviewed.The mean period of followed-up was 2 6 years.Results 39 of the 48 cases of freacture dislocation of the hip complicated with sciatic nerve injury,were treated with surgery.Following open reduction of the fracture and dislocation,the sciatic nerve was explored,neurolysis and anastomosis of the injured ends were performed.21 cases had the surgery within one week after the injury 8 cases within 1～2 weeks,3 cases within 2～3 weeks and 7 cases had surgery 3 months after the injury.The follow up period lasted for 1～4 years and an average of 2 6 years.According to MCRRs criteria,the 32 cases operated upon within 3 weeks after the injury,there were 18 cases obtained excellent results,8 cases had good results,8 cases fair and 1 poor.The 7 cases operated upon at the time from 3 weeks to 3 months after injury 1 case showed excellent result,3 good,1 fair,2 poor.Conclusion Timely Operation,anatomical reduction and early exploration of the sciatic nerve are the key points for decreasing the occurrence of traumatic arthritis of the hip and promoting the recovery of the sciatic nerve function.

关 键 词：髋关节 坐骨神经 骨折 脱位 治疗 

分 类 号：R683.305[医药卫生—骨科学]