改良Kocher-Langenbeck入路在复杂髋臼骨折手术中的应用效果分析  

Application Effect of Modified Kocher-Langenbeck Approach in Complex Acetabular Fracture Surgery

作　　者：章吉林 Zhang Jilin(Department of Orthopedics,Shenzhen Hengsheng Hospital Affiliated to Southern Medical University,Shenzhen City,Guangdong 518100,China)

机构地区：[1]南方医科大学附属深圳恒生医院骨科,广东深圳518100

出　　处：《中国烧伤创疡杂志》2020年第3期183-186,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的探讨改良Kocher-Langenbeck (K-L)入路在复杂髋臼骨折手术中的应用效果。方法回顾性分析2013年1月至2018年6月南方医科大学附属深圳恒生医院骨科收治的84例复杂髋臼骨折患者的病历资料,将48例行改良Stoppa入路联合改良K-L入路手术治疗者设为观察组,36例行改良Stoppa入路联合传统K-L入路手术治疗者设为对照组,对比两组患者手术时间、术中出血量、骨折愈合时间、骨折复位效果、髋关节功能恢复情况以及并发症发生情况。结果观察组患者手术时间明显短于对照组(t=14.660,P=0.000),术中出血量明显少于对照组(t=22.930,P=0.000),骨折愈合时间及骨折复位效果与对照组无明显差异(t=0.449,P=0.655;Z=-0.103,P=0.918),末次随访时髋关节功能明显优于对照组(Z=-2.412,P=0.016),并发症发生情况与对照组无明显差异(χ~2=1.393,P=0.238)。结论在复杂髋臼骨折手术治疗中,与传统K-L入路相比,保护髋外旋短肌群的改良K-L入路能够有效减少术中出血量,减轻局部组织损伤,改善术后髋关节功能,且不影响手术复位效果及骨折愈合时间,临床应用价值较高。Objective To explore the application effect of modified Kocher-Langenbeck(K-L) approach in complex acetabular fracture surgery.Methods The medical records of 84 patients with complex acetabular fractures,admitted to the Department of Orthopedics,Shenzhen Hengsheng Hospital Affiliated to Southern Medical University from January2013 to June 2018,were retrospectively analyzed.Among them,48 patients treated with modified Stoppa approach combined with modified KL approach were set as observation group while 36 patients treated with modified Stoppa approach combined with traditional KL approach were set as control group.Such factors as surgery time,blood loss during surgery,fracture healing time,fracture reduction effect,the recovery of hip joint function and the occurrence of complications were compared between the two groups.Results The surgery time of the observation group was significantly shorter than the control group(t=14.660,P=0.000) and the blood loss during surgery of the observation group was significantly less than the control group(t=22.930,P=0.000).No significant difference was observed in fracture healting time and fracture reduction effect between the two groups(t=0.449,P=0.655;Z=-0.103,P=0.918),the last follow-up showed that hip function of the observation group was significantly better than the control group(Z=-2.412,P=0.016) and no significant difference was observed in the occurrence of complications between the groups(χ~2=1.393,P=0.238).Conclusion Compared with traditional KL approach,modified KL approach can protect hip external rotators,reduce blood loss and local tissue damage during the surgery,and improve hip joint function after sugery.It does not affect reduction effect,nor prolongs fracture healing time.Therefore,it has high clinical application value.

关 键 词：髋臼骨折 改良Kocher-Langenbeck入路 髋外旋短肌群 改良STOPPA入路 骨折复位 髋关节功能 

分 类 号：R687.3[医药卫生—骨科学]