两种入路手术治疗髋臼骨折的疗效比较  

The effect of two approaches surgery for treatment of acetabular fracture

作　　者：钱锦锋[1] 黄伟[1] QIAN Jin-feng;HUANG Wei(SectionⅣ,Dept of Orthopaedics,the Hospital of Marine Police Corps of the Chinese People′s Armed Police Force,Jiaxing,Zhejiang 314000,China)

机构地区：[1]中国人民武装警察部队海警总队医院骨四科,浙江嘉兴314000

出　　处：《临床骨科杂志》2023年第5期702-706,共5页Journal of Clinical Orthopaedics

基　　金：浙江省嘉兴市科技局科技计划项目(编号:2021AD30052)。

摘　　要：目的比较髂腹股沟与腹直肌外侧入路手术治疗髋臼骨折的疗效。方法将50例髋臼骨折患者根据随机数字表法分为对照组(采用髂腹股沟入路切开复位内固定治疗,25例)和观察组(采用腹直肌外侧入路切开复位内固定治疗,25例)。记录骨折愈合时间及并发症发生情况,根据Matta影像学评估标准评估髋臼骨折复位质量,采用疼痛VAS评分评估疼痛情况,采用改良Merle D′Aubigne-Postel评分系统评价髋关节功能。结果患者均获得随访,时间6~24个月。骨折复位质量优良率和骨折愈合时间两组比较差异均无统计学意义(P>0.05)。观察组术中3例发生腹膜损伤。对照组术后5例出现股前外侧皮神经损伤症状。术后3 d疼痛VAS评分观察组低于对照组(P<0.05)。术后6个月髋关节功能优良率观察组高于对照组(P<0.05)。结论与髂腹股沟入路相比,腹直肌外侧入路手术治疗髋臼骨折疼痛缓解较好,髋关节功能恢复满意。Objective To compare the efficacy of ilioinguinal and lateral rectus abdominis approach in the treatment of acetabular fractures.Methods The 50 patients with acetabular fractures were divided into control group(25 cases were treated with ilioinguinal approach and open reduction internal fixation)and observation group(25 cases were treated with lateral rectus abdominis approach and open reduction internal fixation),according to random number table method.The healing time and complications were recorded.The quality of acetabular fracture reduction was evaluated according to the Matta imaging evaluation criteria.The pain VAS was used to evaluate the pain condition.The hip function was assessed with modified Merle D′Aubigne-Postel scoring system.Results All patients were followed up for 6~24 months.There were no statistical significance in the excellent-good rate of fracture reduction quality and fracture healing time between the two groups(P>0.05).Peritoneal injury occurred in 3 patients of the observation group.In the control group,5 cases showed symptoms of femoral anterolateral cutaneous nerve injury.The pain VAS score at 3 d after operation was lower in the observation group than in the control group(P<0.05).At 6 months after operation,the excellent-good rate of hip joint function in the observation group was higher than that in the control group(P<0.05).Conclusions Compared with the ilioinguinal approach,the lateral rectus abdominis approach surgery for treatment of acetabular fracture has better pain relief and satisfactory hip function recovery.

关 键 词：髋臼骨折 髂腹股沟入路 腹直肌外侧入路 内固定 

分 类 号：R383.3[医药卫生—医学寄生虫学] R687.32[医药卫生—基础医学]