腹直肌外侧入路结合后柱内固定治疗复杂髋臼骨折80例  

Clinical Report of 80 Cases of Complex Acetabular Fractures Treated with Lateral Rectus Abdominis Approach Combined with Posterior Column Internal Fixation

作　　者：钱钧 王浩宇 方智敏 QIAN Jun;WANG Haoyu;FANG Zhimin(Department of Orthopedics,Quzhou Hospital Affiliated to Wenzhou Medical University(Quzhou People's Hospital),Quzhou 324000,Zhejiang China)

机构地区：[1]温州医科大学附属衢州医院(衢州市人民医院)骨科,浙江衢州324000

出　　处：《中国中医骨伤科杂志》2022年第8期64-67,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：衢州市科技局指导性项目(2019ASA90155)。

摘　　要：目的:探究经腹直肌外侧入路结合通道后柱内固定治疗复杂髋臼骨折患者对围手术期指标与并发症的影响。方法:选取2018年3月至2021年3月在本院进行手术治疗的复杂髋臼骨折患者80例。患者均行腹直肌外侧入路结合通道后柱内固定治疗。术后随访6个月,记录患者围手术期指标、髋关节功能、骨折复位、生活质量及术后并发症情况。结果:所有患者均顺利完成手术,且患者手术时间(2.14±0.32)h,术中失血量为(316.26±48.05)mL、切口长度为(9.10±0.52)cm、引流管拔除时间为(1.51±0.42)d、术后引流量为(120.52±21.64)mL。经随访,患者均无神经损害症状加重,均未出现肺部感染、肺不张、胸腔积液、泌尿系感染和症状性血栓等并发症。Matta影像学评估复位情况,其中优25例、良31例、中11例、差13例,优良率为83.75%。术后6个月,患者的Harris评分及SF-36评分均显著高于术前,差异均具有统计学意义(P<0.05)。结论:经腹直肌外侧入路结合通道后柱内固定治疗复杂髋臼骨折的复位效果好,可有效改善患者髋关节功能,提高患者生活质量,且该术安全性高,术后并发症少。Objective:To explore the influence of translateral rectus abdominis approach combined with posterior column internal fixation on the treatment of patients with complex acetabular fractures on perioperative indicators and complications.Methods:A total of 80patients with complex acetabular fractures who underwent surgical treatment in hospital from March 2018to March 2021 were selected as the research subjects.All patients underwent lateral rectus abdominis approach combined with channel posterior column internal fixation.The patients were followed up for 6months,and the perioperative indexes,hip joint function,fracture reduction,quality of life and postoperative complications were recorded.Results:All patients successfully completed the operation,and the operation time of the patients was(2.14±0.32)h,the intraoperative blood loss was(316.26±48.05)mL,the incision length was(9.10±0.52)cm,the drainage tube removal time was(1.51±0.42)d,The postoperative drainage volume was(120.52±21.64)mL.None of the patients had worsening symptoms of neurological damage after follow-up,and no complications such as pulmonary infection,atelectasis,pleural effusion,urinary tract infection and symptomatic thrombosis occurred.And Matta imaging evaluation of reduction showed 25cases were excellent,31cases were good,11cases were moderate,and 13cases were poor,with an excellent and good rate of 83.75%.In addition,the Harris score and SF-36score of patients 6months after operation were significantly higher than those before operation,and the difference was statistically significant(P<0.05).Conclusion:Translateral rectus abdominis approach combined with channel posterior internal fixation has a good reduction efficacy on the treatment of complex acetabular fractures,which can effectively improve the function of the patient's hip joint and improve the quality of life of the patient.The operation is safe and has fewer postoperative complications.

关 键 词：髋臼骨折 腹直肌外侧入路 通道后柱内固定 并发症 

分 类 号：R683.42[医药卫生—骨科学]