方形区支撑钢板治疗骨质疏松性髋臼骨折  

The quadrilateral buttress plates in the treatment of osteoporotic acetabular fractures

作　　者：胡维界 张国劼 刘峰 段磊 张军钰 李煜 HU Wei-jie;ZHANG Guo-jie;LIU Feng;DUAN Lei;ZHANG Jun-yu;LI Yu(Dept of Orthopaedics,the Second People′s Hospital of Qingyang,Qingyang,Gansu745000,China)

机构地区：[1]庆阳市第二人民医院骨科

出　　处：《临床骨科杂志》2019年第4期424-426,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨方形区支撑钢板治疗骨质疏松性髋臼骨折的临床疗效。方法采用改良Stoppa入路结合方形区支撑钢板行切开复位内固定技术治疗25例老年骨质疏松性髋臼骨折患者。采用改良Matta髋臼骨折复位标准、PMA功能评分标准、HHS髋关节评分评价术后疗效。记录随访过程中出现的并发症。结果25例患者均获得随访,时间12~35个月。手术时间80~160min,术中出血量400~1200ml。术后次日根据改良Matta髋臼骨折复位标准评价疗效:解剖复位13例,良好复位9例,不满意复位3例。末次随访时,根据改良PMA髋关节功能评分评价疗效:优9例,良14例,可1例,差1例;根据HHS髋关节评分评价疗效:优11例,良6例,可5例,差3例。随访过程中有3例二次行全髋关节置换术。结论采用改良Stoppa入路结合方形区支撑钢板行切开复位内固定技术治疗骨质疏松性髋臼骨折,具有临床疗效可靠、并发症少等特点,治疗前柱髋臼骨折临床疗效更佳。Objective To explore the clinical efficacy of the treatment of osteoporotic acetabular fractures with quadrilateral buttress plate.Methods The 25 patients with osteoporotic acetabular fractures were performed with open reduction and internal fixation with buttress plate via modified Stoppa approach.The modified Matta radiological system reduction criteria,modified Postel-Merle d′Aubigné(PMA)evaluation system and Harris hip score were used to assess postoperative efficacy,and complications were recorded during the follow-up.Results Twenty-five patients were followed up from 12 months to 35 months.The operation time ranged from 80 min to 160 min.The intraoperative blood bleeding ranged from 400 ml to 1 200 ml.By the modified Matta evaluation system on the next day after surgery,13 cases had anatomic reduction,9 cases were satisfactory reduction,and 3 cases were dissatisfactory reduction.According to the modified PMA evaluation system at the last follow-up,9 cases were excellent,14 cases good,1 fair and 1 poor.According to the Harris hip score evaluation system at the last follow-up,11 cases were excellent,6 cases good,5 fair and 3 poor.Three cases underwent the secondary total hip arthroplasty during the follow-up.Conclusions Open reduction and internal fixation with quadrilateral buttress plate with modified Stoppa approach can be used in clinical treatment of osteoporotic acetabular fractures,which have the advantages of reliable clinical outcomes and fewer complication,especially in the treatment of anterior column acetabular fracture.

关 键 词：髋臼骨折 方形区 支撑钢板内固定 骨质疏松 

分 类 号：R683.3[医药卫生—骨科学]