改良Stoppa入路内髂坐钢板固定治疗涉及后柱的髋臼骨折  

Operative treatment of acetabular fractures involving the posterior column with ilioischial plating via the modified Stoppa approach

作　　者：薛飞[1] 贾文超 武剑[1] 佟雁翔[1] 王文选[1] 贾燕飞[1] 冯卫[1] Xue Fei;Jia Wenchao;Wu Jian;Tong Yanxiang;Wang Wenxuan;Jia Yanfei;Feng Wei(Department of Orthopaedics,The Second Affiliated Hospital to Mongolia Medical University,Hohhot 010030,China)

机构地区：[1]内蒙古医科大学第二附属医院骨科,呼和浩特010030

出　　处：《中华创伤骨科杂志》2019年第6期478-483,共6页Chinese Journal of Orthopaedic Trauma

基　　金：内蒙古自然科学基金(2017MS0836).

摘　　要：目的探讨改良Stoppa入路内髂坐钢板固定治疗涉及后柱的髋臼骨折的临床疗效。方法回顾性分析2017年1月至2018年6月期间内蒙古医科大学第二附属医院骨科收治的12例涉及后柱的髋臼骨折患者资料。男7例,女5例;年龄为35~62岁,平均43.3岁。骨折根据Letournel-Judet分型:横形骨折5例,前柱伴后半横形骨折4例,双柱骨折3例。所有患者均采用改良Stoppa入路内髂坐钢板固定治疗。记录患者的手术时间、术中出血量、术后骨折复位质量及并发症发生情况等。末次随访时采用改良的Merled’Aubigné&Postel评分系统评定患髋功能。结果本组患者的手术时间平均为130min(90~170min),术中出血量平均为550mL(400~700mL),术中未发生大出血。12例患者术后获6~16个月(平均8个月)随访。根据Matta评分标准评定术后骨折复位质量:优10例,良2例。12例患者的骨折愈合时间为8~10周(平均8.7周)。末次随访时根据改良Merled' Aubigne & Postel评分系统评定患髋功能:评分为12~18分,平均16分;优6例,良4例,可2例。随访期间无一例患者发生骨折再移位、神经损伤、深静脉血栓形成及异位骨化等并发症。结论对于涉及后柱的髋臼骨折,改良Stoppa入路内髂坐钢板固定具有复位及维持复位容易、并发症少及疗效好等优点。Objective To evaluate ilioischial plating via the modified Stoppa approach for acetabular fractures involving the posterior column. Methods A retrospective analysis was conducted of the 12 patients who had been treated for acetabular fractures involving the posterior column from January 2017 to June 2018 by ilioischial plating via the modified Stoppa approach at Department of Orthopaedics, The Second Affiliated Hospital to Mongolia Medical University. They were 7 males and 5 females, aged from 35 to 62 years (average, 43.3 years). According to the Letournel-Judet classification, there were 5 transverse fractures, 4 anterior column plus posterior hemitransverse fractures and 3 both column fractures. Ilioischial plating was conducted for all the patients via the modified Stoppa approach. The Matta criteria were used to evaluate the fracture reduction. The operative time, intraoperative bleeding volume, postoperative fracture reduction and complications like traumatic arthritis and deep venous thrombosis were recorded. Merle d’Aubigné and Postel scoring was used to evaluate hip function during follow-up. Results The operative time for this group averaged 130 min (from 90 to 170 min) and the intraoperative blood loss 550 mL (from 400 to 700 mL). No major intraoperative bleeding occurred. All the 12 patients were followed up for 6 to 16 months (average, 8 months). The Matta evaluation for reduction quality yielded 10 excellent and 2 good cases. Their fractures healed after 8 to 10 weeks (average, 8.7 weeks). At the last follow-up, the affected hips scored 12 to 18 points (average, 16 points), giving 6 excellent, 4 good and 2 fair cases. Follow-ups revealed no fracture re-displacement, nerve injury, deep vein thrombosis, ectopic ossification or other complications. Conclusion In the operative treatment of complex acetabular fractures involving the posterior column, ilioischial plating via the modified Stoppa approach displays advantages of easy reduction, easy maintenance of the reduction, limited complications and

关 键 词：髋臼 骨折 骨折固定术 内 骨板 手术入路 

分 类 号：R687.3[医药卫生—骨科学]