重建钢板联合T型钢板内固定治疗髋臼后壁骨折  

Internal fixation of reconstruction plate combined with T-plate for posterior wall fracture of acetabulum

作　　者：王宝 兰贺军 张楠[3] 关鹏飞[4] WANG Bao;LAN Hejun;ZHANG Nan;GUAN Pengfei(Department of Orthopedics,Linxi Hospital,Kailuan General Hospital,Tangshan 063103,Hebei,China;Department of Surgery,Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,Hebei,China;Department of Orthopedics,Kailuan General Hospital,Tangshan 063000,Hebei,China;The Fifth Department of Trauma Surgery,The Second Hospital of Tangshan,Tangshan 063000,Hebei,China)

机构地区：[1]开滦总医院林西医院骨科,河北唐山063103 [2]唐山市中医医院外科,河北唐山063000 [3]开滦总医院骨科,河北唐山063000 [4]唐山市第二医院创伤五科,河北唐山063000

出　　处：《中国现代手术学杂志》2023年第6期469-474,共6页Chinese Journal of Modern Operative Surgery

基　　金：河北省卫生健康委科研基金项目(20191344)。

摘　　要：目的探讨重建钢板联合T型钢板内固定治疗髋臼后壁骨折的临床效果。方法回顾性分析2018年1月至2021年12月手术治疗的76例髋臼后壁骨折患者的临床资料,按手术方式分为两组,分别采用重建钢板联合T型钢板内固定(观察组,n=38例)和平行双解剖锁定钢板内固定(对照组,n=38例)。比较两组手术相关指标、骨折复位质量、术后髋关节功能及并发症情况。结果两组均顺利完成手术。观察组手术时间和术中出血量明显少于对照组,满意复位率高于对照组,差异均有统计学意义(P<0.05)。两组患者均获得随访,随访时间6~18个月。末次随访按改良Merled'Aubigne-Postel标准评价髋关节功能:观察组优22例,良14例,可2例,对照组优14例,良15例,可8例,差1例;观察组优良率明显高于对照组(94.74%vs.76.32%,P<0.05)。观察组术后发生下肢静脉血栓和深部感染各1例,对照组发生下肢静脉血栓2例,深部感染3例,术后剧烈疼痛3例。两组并发症发生率比较,对照组高于观察组,差异有统计学意义(21.05%vs.5.26%,P<0.05)。结论重建钢板联合T型钢板内固定治疗髋臼后壁骨折可获得理想的复位效果,恢复髋关节功能,降低并发症发生率。Objective To explore the clinical value of internal fixation of reconstruction plate combined with T-shaped plate for the treatment of acetabular posterior wall fractures.Methods The clinical data of 76 cases with acetabular posterior wall fractures admitted to Linxi Hospital of Kailuan General Hospital from January 2018 to December 2021 were analyzed retrospectively.According to surgical procedure,all cases were divided into observation group(n=38)and control group(n=38),and performed internal fixation with reconstruction plate combined with T-plate and parallel double anatomical locking plate respectively.The peri-operative related indexes,fracture reduction,hip function evaluation and incidence of complications were compared between the two groups.Results All operations were completed successfully.Compared with the control group,the operation time and intra-operative blood loss was less,the rate of satisfactory reduction was higher in the observation group,and the differences were significant(P<0.05).All cases were followed up for 6 to 18 months.The function evaluation revealed that excellence was in 22 cases,good in 14 cases and fair in 2 cases of the observation group,and excellence in 14 cases,good in 15 cases,fair in 8 cases and false in 1 case of the control group,and the fineness rate was higher in the observation group than that in the control group(94.74%vs.76.32%,P<0.05).Lower limb vein thrombosis and deep infection was found in 1 case respectively after the surgery in the observation group,with the complication rate of 5.26%,and lower limb vein thrombosis was in 2 cases,deep infection in 3 cases and severe postoperative pain in 3 cases in the control group,with the complication rate of 21.05%.There was significant difference in post-operative complication rate between the two groups(P<0.05).Conclusion The internal fixation of reconstruction plate combined with T-plate can achieve an ideal reduction and restore the hip function for acetabular posterior wall fractures with lower complication incidence.

关 键 词：髋臼后壁骨折 骨折固定术 内 重建钢板 T型钢板 

分 类 号：R687.3[医药卫生—骨科学]