新型H形解剖钛板治疗髋臼后壁/后柱骨折  

Application of new H-shaped anatomical titanium plate for posterior wall/posterior column acetabular fractures

作　　者：黄杰鑫 廖明新 陈小杰 HUANG Jiexin;LIAO Mingxin;CHEN Xiaojie(Department of Orthopedics,Nanping First Hospital Affiliated to Fujian Medical University,Nanping Fujian,353000,P.R.China)

机构地区：[1]福建医科大学附属南平第一医院骨科,福建南平353000

出　　处：《中国修复重建外科杂志》2021年第1期64-69,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：福建医科大学启航基金项目(2019QH1241)。

摘　　要：目的探讨新型H形解剖钛板治疗髋臼后壁/后柱骨折的疗效。方法 2012年3月—2019年4月,应用新型H形解剖钛板治疗46例累及后壁/后柱的髋臼骨折患者。男28例,女18例;年龄20~70岁,平均45.5岁。致伤原因:交通事故伤34例,高处坠落伤12例。受伤至手术时间2~14 d,平均7 d。Letournel-Judet分型:后壁骨折12例、后柱骨折1例、横形骨折3例、横形伴后壁骨折9例、后柱伴后壁骨折8例、前柱伴后半横形骨折2例、T形骨折3例、双柱骨折8例。术后采用Matta评价标准评定骨折复位情况,Merle d’Aubign-Postel评分标准评价髋关节功能。结果 46例均顺利完成手术;后路手术时间60~120 min,平均80 min;术中出血量200~600 mL,平均300 mL。术后切口均Ⅰ期愈合,无感染、下肢深静脉血栓形成、坐骨神经损伤等并发症发生。患者均获随访,随访时间6~72个月,平均37个月。骨折复位根据Matta评价标准评定,获解剖复位40例、满意复位4例、不满意复位2例,满意率为95.7%(44/46);骨折均愈合,愈合时间为3~6个月,平均4.3个月;随访期间无内固定失效发生。末次随访时Merle d’Aubign-Postel评分为6~18分,平均15.5分;其中优38例、良4例、可2例、差2例,优良率为91.3%(42/46)。术后4例发生异位骨化,4例发生创伤性关节炎,2例发生股骨头坏死。结论对于累及后壁/后柱的髋臼骨折,新型H形解剖钛板可以提供牢固固定,术后骨折复位满意,髋关节功能恢复良好。Objective To explore the effectiveness of a new H-shaped anatomical titanium plate in treatment of posterior wall/posterior column acetabular fractures.Methods Between March 2012 and April 2019,46 patients with acetabular fractures involving posterior wall/posterior column were treated with the new H-shaped anatomical titanium plates.There were 28 males and 18 females.The age ranged from 20 to 70 years,with an average of 45.5 years.Among the patients,34 cases were injured by traffic accidents and 12 cases by falling from height.The time from injury to operation ranged from 2 to 14 days,with an average of 7 days.According to Letournel-Judet classification,there were 12 cases of posterior wall fractures,1 case of posterior column fracture,3 cases of transverse fractures,9 cases of transverse fractures involving posterior walls,8 cases of posterior column and posterior wall fractures,2 cases of anterior column and posterior semi-transverse fractures,3 cases of T-shaped fractures,and 8 cases of double column fractures.Matta reduction standard was used to evaluate fracture reduction and Merle d’Aubign-Postel score was used to evaluate hip joint function.Results All operations were successfully completed.The time of posterior operation was 60-120 minutes,with an average of 80 minutes.The amount of intraoperative blood loss ranged from 200 to 600 mL,with an average of 300 mL.All the incisions healed by first intention and no infection,deep vein thrombosis,or sciatic nerve injury occurred.All 46 patients were followed up 6-72 months,with an average of 37 months.According to Matta reduction standard,40 cases obtained anatomic reduction,4 cases satisfactory reduction,2 cases unsatisfactory reduction,and the satisfaction rate was 95.7%(44/46).All fractures healed,and the healing time was 3-6 months,with an average of 4.3 months.No internal fixation failure occurred during the follow-up.At last follow-up,the Merle d’Aubign-Postel score ranged from 6 to 18(mean,15.5),including 38 cases of excellent,4 cases of good,2 cases

关 键 词：髋臼骨折 后柱骨折 后壁骨折 新型H形解剖钛板 内固定 

分 类 号：R687.3[医药卫生—骨科学]