第一代与第二代动力化前路方形区钛板螺钉内固定系统治疗髋臼T形骨折的疗效比较  

Dynamic anterior plate-screw system for quadrilateral area in T-shaped acetabular fractures:a comparison of clinical efficacy between the first and the second generation

作　　者：邵启鹏 蔡贤华 吴海洋[1,2] 尚冉冉 宋成[1] 刘曦明 汪国栋 Shao Qipeng;Cai Xianhua;Wu Haiyang;Shang Ranran;Song Chengjing;Liu Ximing;Wang Guodong(Department of Orthopaedics,General Hospital of Central Theater Command,Clinical Medical Research Center of Bone Trauma in Hubei Province,Wuhan 430070,China;Graduate School,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]解放军中部战区总医院骨科,湖北省创伤救治临床医学研究中心,武汉430070 [2]南方医科大学研究生院,广州510515

出　　处：《中华创伤骨科杂志》2021年第3期246-253,共8页Chinese Journal of Orthopaedic Trauma

基　　金：湖北省技术创新专项重大项目(2017ACA099)。

摘　　要：目的比较第1代与第2代动力化前路方形区钛板螺钉内固定系统(DAPSQ)治疗髋臼T形骨折的临床疗效。方法回顾性分析2008年1月至2019年12月期间解放军中部战区总医院骨科采用手术治疗的28例髋臼T形骨折患者资料。根据内固定方式不同分为两组:A组15例,男11例,女4例;年龄为(43.5±9.1)岁;采用第1代DAPSQ固定治疗。B组13例,男8例,女5例;年龄为(42.5±7.0)岁;采用第2代DAPSQ固定治疗。记录并比较两组患者的手术时间、术中出血量、骨折复位质量、患髋功能及术后并发症发生情况等。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。28例患者术后获12~60个月(平均35.0个月)随访。B组患者的手术时间[(193.9±33.3)min]和术中出血量[(830.8±177.4)mL]显著少于A组患者[(231.3±40.0)min、(1043.3±190.7)mL],差异均有统计学意义(P<0.05)。骨折复位质量根据Matta评分标准评定:A组优8例,良5例,差2例;B组优8例,良4例,差1例。末次随访时按改良Merle d'Aubigné&Postel评分系统评定患髋功能:A组优9例,良3例,可2例,差1例;B组优9例,良2例,可2例。两组患者的骨折复位质量和患髋功能比较差异均无统计学意义(P>0.05)。随访期间A组和B组分别有2、1例患者发生髋关节创伤性关节炎。结论与第1代DAPSQ相比,第2代DAPSQ可显著缩短髋臼T形骨折患者的手术时间、减少术中出血量,且二者临床功能相当。Objective To compare the clinical efficacy between our first generation and second generation dynamic anterior plate-screw system for quadrilateral area(DAPSQ)in the treatment of T-shaped acetabular fractures.Methods A retrospective study was conducted of the 28 patients with T-shaped acetabular fractures who had been treated at Department of Orthopaedics,General Hospital of Central Theater Command from January 2008 to December 2019.They were divided into 2 groups according to fixation methods.Group A[15 patients,11 males and 4 females,an age of(43.5±9.1)years]were treated with the first generation DAPSQ while Group B[13 patients,8 males and 5 females,an age of(42.5±7.0)years]with the second generation DAPSQ.Operation time,intraoperative bleeding,fracture reduction,function of the affected hip and postoperative complications were recorded and compared between the 2 groups.Results The 2 groups were comparable because there was no significant difference between them in the preoperative general data(P>0.05).The 28 patients were followed up for 12 to 60 months(average,35.0 months).The operation time[(193.9±33.3)min]and intraoperative bleeding[(830.8±177.4)mL]for Group B were significantly less than those for Group A[(231.3±40.0)min and(1,043.3±190.7)mL](P<0.05).In Group A,according to the Matta scoring,the fracture reduction was rated as excellent in 8 cases,good in 5 and poor in 2;in Group B,the fracture reduction was rated as excellent in 8 cases,good in 4 and poor in one.According to the modified Merle d'Aubigné&Postel scoring at the final follow-up,the function of the affected hip was rated as excellent in 9 cases,as good in 3,as fair in 2 and as poor in one in Group A while as excellent in 9 cases,as good in 2 and as fair in 2 in Group B.There were no statistically significant differences between the 2 groups in reduction quality or in the function of the affected hip(P>0.05).Follow-up observed hip traumatic arthritis in 2 cases in Group A and in one in Group B.Conclusion In the treatment of T-shaped acet

关 键 词：髋臼 骨折 骨折固定术 内 骨板 

分 类 号：R687.3[医药卫生—骨科学]