骨盆前壁锁定钢板固定累及方形区的髋臼骨折  

Anterior locking plate for internal fixation of acetabular fractures involving quadrilateral area

作　　者：王治栋[1] 王振恒 陈广东[1] 高懋峰[1] 施卫东[1] 杨惠林[1] 朱若夫[1] WANG Zhi-dong;WANG Zhen-heng;CHEN Guang-dong;GAO Mao-feng;SHI Wei-dong;YANG Hui-lin;ZHU Ruo-fu(Department of Orthopedics,The First Affili-ated Hospital,Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《中国矫形外科杂志》2022年第6期555-558,共4页Orthopedic Journal of China

摘　　要：[目的]探讨骨盆前壁锁定钢板治疗累及方形区的髋臼骨折的临床疗效。[方法]回顾性分析本院2017年1月—2020年12月应用骨盆前壁锁定钢板治疗累及方形区髋臼骨折32例患者的临床资料。其中,前壁伴后半横型骨折6例,横型骨折7例,双柱骨折12例,T型骨折7例。通过腹直肌外侧入路显露髋臼,选择骨盆前壁锁定钢板结合重建钢板固定。总结临床与影像资料。[结果]32例患者均顺利完成手术,术中无血管、神经损伤。随访时间12~41个月,平均(25.84±10.95)个月。患者完全负重活动时间为(11.93±3.62)周。随时间推移,患髋伸屈和内外旋ROM显著增加(P<0.05)。按Merled'Aubigné⁃Postel评级,优22例、良6例、可3例、差1例,优良率为87.50%(28/32);根据Matta影像学评估,解剖复位23例(71.88%),满意复位7例(21.88%),不满意复位2例(6.25%),满意率为93.75%(30/32),末次随访时,所有患者均达到骨性愈合,无异位骨化、股骨头坏死和内固定松动等不良表现。[结论]骨盆前壁锁定钢板固定累及方形区髋臼骨折可靠,临床疗效满意。[Objective]To explore the clinical outcomes of the anterior locking plate for internal fixation of acetabular fractures involv⁃ing quadrilateral area.[Methods]A retrospective study was done on 32 patients who received open reduction and internal fixation(ORIF)for acetabular fractures involving quadrilateral area in our hospital from January 2017 to December 2020.Based on Letournel-Judet classi⁃fication,6 patients were of anterior wall combined with posterior semi-transverse fractures,7 were of transverse fractures,12 were of dou⁃ble-column fractures and 7 of T-shaped fractures.All patients had fractures fixed with anterior locking plate combined with the reconstruc⁃tion plate through the lateral rectus approach.The clinical and radiographic documents were summarized.[Results]All patients had ORIF performed smoothly without iatrogenic injury to blood vessels and nerves,and followed up for 12~41 months,with an average of(25.84±10.95)months.The patients resumed full-weight bearing activity in(11.93±3.62)weeks on average,and got significant increases of hip flex⁃ion-extension and internal-external rotation range of motions(ROM)over time.According to Merled'Aubigné⁃Postel criteria,the clinical outcomes were marked as excellent in 22,good in 6,fair in 3 and poor in 1,with excellent and good rate of 87.50%(28/32).In term of Mat⁃ta criteria,anatomic reduction achieved in 23 cases(71.88%),satisfactory reduction was in 7 cases(21.88%)and unsatisfactory reduction was in 2 cases(6.25%),with total satisfactory rate of 93.75%(30/32).To the latest follow up,all the patients got fracture healing without adverse imaging findings,such as heterotrophic ossification,femoral head necrosis and implant loosening.[Conclusion]The anterior lock⁃ing plate for internal fixation of acetabular fractures involving the quadrilateral area is reliable technique to achieve satisfactory clinical out⁃comes.

关 键 词：髋臼骨折 方形区 入路 钢板 

分 类 号：R683.3[医药卫生—骨科学]