后壁负重区加用管型钢板治疗髋臼后壁骨折的疗效  

The effect of adding use of tubular plate in the weight-bearing area of acetabular posterior wall on the posterior wall fracture of acetabulum

作　　者：鲍昌珅 罗建 戴丹锋 孟永骏 BAO Chang-shen;LUO Jian;DAI Dan-feng;MENG Yong-jun(Dept of Orthopaedics,Linping Campus of the Second Hospital Affiliated of Zhejiang University,the First People′s Hospital of Linping District of Hangzhou,Hangzhou,Zhejiang 311100,China)

机构地区：[1]浙江大学附属第二医院临平院区(杭州市临平区第一人民医院)骨科,浙江杭州311100

出　　处：《临床骨科杂志》2023年第4期561-564,共4页Journal of Clinical Orthopaedics

摘　　要：目的 探讨后壁负重区加用管型钢板治疗髋臼后壁骨折的疗效。方法 采用传统3.5 mm纵向重建钢板固定治疗18例髋臼后壁骨折患者,在后壁负重区加用管型钢板固定。结果 患者均获得随访,时间7~21个月。术后根据Matta标准评估骨折复位质量:解剖复位12例,良好5例,差1例。术后完全负重时间10~14周。骨折均愈合,时间12~20周。术后1例因股骨头缺血性坏死导致髋关节慢性疼痛,于术后1年行髋关节置换术治疗;其余患者随访期间未发生骨折再移位、切口深部感染、螺钉穿透、内固定物松动或断裂以及下肢深静脉血栓形成等并发症。末次随访时采用改良d′Aubigne-Postal评分评价患髋功能:优9例,良6例,可2例,差1例,优良率为15/18。结论 在髋臼后壁骨折的治疗中,对累及负重区的后壁骨折块加用管型钢板固定,有利于中和该区域巨大的应力,减少内固定失效的风险,临床疗效满意。Objective To investigate the effect of adding use of tubular plate in the weight-bearing area of acetabular posterior wall on the posterior wall fracture of acetabulum.Methods The 18 patients with posterior wall fractures of acetabulum were treated with traditional longitudinal 3.5 mm reconstruction plates fixation,and the posterior wall weight-bearing area was fixed with tubular plate.Results All patients were followed up for 7~21 months.Postoperative quality of fracture reduction was evaluated according to Matta criteria:12 cases got anatomical reduction,5 cases got good reduction,1 case was poor reduction.The full weight-bearing time was 10~14 weeks after surgery.All the fractures healed within 12~20 weeks.One patient with chronic hip pain due to avascular necrosis of the femoral head,who was performed with hip replacement at 1 year after surgery.During follow-up,no complications such as fracture re-displacement,deep incision infection,screw penetration,loosening or rupture of internal fixation,or deep venous thrombosis of lower extremity occurred in other patients.At the last follow-up,the modified d′Aubigne-Postal score was used to evaluate hip function:excellent in 9 cases,good in 6,fair in 2 and poor in 1,with an excellent-good rate of 15/18.Conclusions In the treatment of posterior wall fracture of acetabulum,the adding use of tubular plate fixation on posterior wall fracture fragments of involving weight-bearing area is beneficial to neutralize the huge stress in this area,which can reduce the risk of internal fixation failure,and the clinical effect is satisfactory.

关 键 词：髋臼后壁骨折 髋臼负重区 内固定 

分 类 号：R683.3[医药卫生—骨科学] R687.32[医药卫生—外科学]