真骨盆缘完整的髋臼高位前柱骨折的疗效分析  

Effect Analysis of High Anterior Column Fracture of Acetabulum with Complete True Pelvic Margin

作　　者：阚鹏 独行业[1] 惠宇坚 殷小军[1] 顾家烨[1] KAN Peng;DU Xingye;HUI Yujian;YIN Xiaojun;GU Jiaye(Department of Orthopedics,Jiangyin People’s Hospital Affiliated to School of Medicine of Southeast University,Jiangyin 214400,China)

机构地区：[1]东南大学医学院附属江阴市人民医院骨科,江苏江阴214400

出　　处：《湖北民族大学学报（医学版）》2022年第4期23-27,共5页Journal of Hubei Minzu University(Medical Edition)

基　　金：江苏江阴市卫健委项目(S202105)。

摘　　要：目的探讨真骨盆缘完整的高位前柱骨折的形态学特点,治疗方法及临床效果。方法回顾性分析2017年1月-2020年8月东南大学医学院附属江阴市人民医院骨科收治的12例真骨盆缘完整的髋臼高位前柱骨折患者资料,9例单纯型骨折患者,7例仅采用髂腹股沟入路第1窗进行手术,2例采用髂腹股沟入路第1窗和第3窗手术,均采用空心拉力螺钉结合重建钢板的方式进行固定;3例合并后壁骨折型患者,2例采用了髂腹股沟入路第1窗联合K-L入路,1例采用了扩展的髂股入路。结果12例术后随访6~45个月,平均28.4个月。手术时间100~200 min,平均134 min;术中出血量300~1000 mL,平均612 mL;6例出现股外侧皮神经牵拉伤,随访时均恢复;术后按Matta影像学评定标准,优10例,良2例,优良率100%;所有患者均骨性愈合,愈合时间3~5个月,平均4.2个月;1例出现异位骨化,Brooker分级I级;末次随访按改良的Merle d’Aubigné和Postel髋关节功能评分系统评定,优10例,良1例,总体优良率100%。结论真骨盆缘完整的髋臼高位前柱骨折是一种特殊类型的髋臼骨折,骨折主要累及髋臼顶,可伴有后壁骨折和髋臼顶的压缩,选择合理的手术入路,解剖复位,合适的内固定,可获得满意的临床疗效。Objective To explore morphological characteristics,treatment methods and clinical effects of high anterior column fracture with complete true pelvic margin.Methods Retrospective analysis of the data of 12 cases with high anterior column fractures with complete true pelvic margin admitted to the Department of Orthopedics of Jiangyin People’s Hospital from January 2017 to August 2022.9 cases with simple type fracture,7 cases were operated only through the first window of ilioinguinal approach,2 cases were operated by the first and third window of ilioinguinal approach,all cases were fixed with hollow lag screws and reconstruction plates;3 cases with posterior wall fracture,the first window of ilioinguinal approach combined with K-L approach was used in 2 cases,and the extended iliofemoral approach was used in 1 case.Results The 12 cases were followed up for 6 to 45 months,with an average of 28.4 months.The operation time was 100~200 min,with an average of 134 min;Intraoperative blood loss was 300~1000 mL,with an average of 612 mL;Traction injury of lateral femoral cutaneous nerve occurred in 6 cases,and all recovered during follow-up;According to the Matta imaging evaluation standard,10 cases were excellent,2 cases were good,and the excellent and good rate was 100%.All patients had bony healing,and the healing time was 3~5 months,with an average of 4.2 months.1 case had heterotopic ossification,Brooker grade I Level;At the last follow-up,according to the modified Merled’Aubignéand Postel hip function scoring system,10 cases were excellent,1 case was good,and the overall excellent and good rate was 100%.Conclusion High anterior column fracture of acetabulum with complete true pelvic margin is a special type of acetabulum fracture,the fracture mainly involves the acetabular roof and may be accompanied by posterior wall fractures and compression of the acetabular roof,reasonable surgical approach,anatomic reduction and appropriate internal fixation can obtain satisfactory clinical results.

关 键 词：真骨盆缘 髋臼 骨折 分类法 

分 类 号：R687.3[医药卫生—骨科学]