改良Bikini入路在髋臼一体化翼形解剖接骨板固定治疗髋臼骨折中的应用  

The modified Bikini approach used for fixation of acetabular fracture with an integrated wing-shaped anatomical locking plate

作　　者：朱振华 麦奇光 李涛 向海波 陈煜辉 廖坚文 樊仕才 Zhu Zhenhua;Mai Qiguang;Li Tao;Xiang Haibo;Chen Yuhui;Liao Jianwen;Fan Shicai(Department of Trauma Orthopaedics,Orthopaedic Medical Center,The Third Hospital Affiliated to Southern Medical University,Guangzhou 510000,China)

机构地区：[1]南方医科大学第三附属医院骨科医学中心创伤骨科,广州510000

出　　处：《中华创伤骨科杂志》2024年第3期194-201,共8页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金(82072411);国家骨科运动医学与康复临床研究中心创新基金培育项目(2021-NCRC-CXJJ-PY-06);国家重点研发计划项目(2022YFC2504303)。

摘　　要：目的探讨改良Bikini入路在髋臼一体化翼形解剖接骨板固定治疗髋臼骨折中的应用效果。方法回顾性分析2017年5月至2021年6月期间南方医科大学第三附属医院骨科医学中心创伤骨科收治的54例髋臼骨折患者资料。根据手术入路不同分为两组:观察组26例,男6例,女20例;年龄40.0(29.8,46.8)岁;采用改良Bikini入路髋臼一体化翼形解剖接骨板固定治疗。对照组28例,男10例,女18例;年龄34.5(24.0,43.5)岁;采用腹直肌外侧入路髋臼一体化翼形解剖接骨板固定治疗。比较两组患者的手术切口长度、手术时间、术中出血量、住院时间、术后骨折复位质量、疼痛视觉模拟评分(VAS)、髋关节功能、温哥华瘢痕量表(VSS)及患者和观察者瘢痕评估量表(POSAS)评分等。结果两组患者术前一般资料的比较差异均无统计学意义(P>0.05),具有可比性。两组患者的手术切口长度、手术时间、术中出血量及住院时间比较差异均无统计学意义(P>0.05)。观察组患者的术后骨折复位质量优良率为100.0%(26/26),术后1个月疼痛VAS评分为2.0(1.0,3.0)分,术后12个月髋关节改良Merle d’’Aubigné & Postel评分为13.5(12.3,14.8)分,与对照组患者[92.9%(26/28)、2.0(1.0,3.0)分、14.0(13.0,15.0)分]比较差异均无统计学意义(P>0.05)。术后12个月观察组患者的VSS评分[4.50(4.00,6.00)分]、POSAS评分[(29.85±10.05)分]显著低于对照组患者[6.50(5.00,8.25)、(37.11±11.75)分],差异均有统计学意义(P<0.05)。结论与腹直肌外侧入路相比,改良Bikini入路髋臼一体化翼形解剖接骨板固定治疗髋臼骨折不仅能取得相当的临床效果,而且具有术后切口瘢痕更小、切口更隐蔽及美观等优势。Objective To investigate the effectiveness of the modified Bikini approach in the fixation of acetabular fracture with an integrated wing-shaped anatomical locking plate.Methods A retrospective study was conducted to analyze the data of 54 patients with acetabular fracture who had been treated at Department of Trauma Orthopedics,Orthopedic Medical Center,The Third Hospital Affiliated to Southern Medical University from May 2017 to June 2021.The patients were divided into 2 groups based on different surgical approaches:an observation group[26 cases,6 males,20 females;aged 40.0(29.8,46.8)years]treated with fixation with an integrated wing-shaped anatomical locking plate through the modified Bikini approach,and a control group[28 cases,10 males,18 females;aged 34.5(24.0,43.5)years]treated with fixation with an integrated wing-shaped anatomical locking plate through the lateral-rectus approach.The incision length,operation time,intraoperative bleeding,length of hospital stay,quality of postoperative fracture reduction,visual analog scale(VAS)for pain,hip function,Vancouver Scar Scale(VSS)and Patient and Observer Scar Assessment Scale(POSAS)were compared between the 2 groups.Results The differences in the preoperative general data between the 2 groups were not statistically significant,indicating comparability(P>0.05).There were no statistically significant differences between the 2 groups either in terms of incision length,operation time,intraoperative bleeding,or hospital stay(P>0.05).The 2 groups were not significantly different in the excellent/good rate of fracture reduction[100.0%(26/26)versus 92.9%(26/28)],VAS at 1 month postoperation[2.0(1.0,3.0)versus 2.0(1.0,3.0)],or the modified Merle d'Aubignéand Postel hip score at 12 months postoperation[13.5(12.3,14.8)versus.14.0(13.0,15.0)](P>0.05).However,the VSS[4.50(4.00,6.00)]and POSAS(29.85±10.05)at 12 months postoperation in the observation group were significantly lower than those in the control group[6.50(5.00,8.25)and 37.11±11.75](P<0.05).Conclusion In the

关 键 词：髋臼 骨折 骨折固定术 内 骨板 改良Bikini入路 

分 类 号：R687.3[医药卫生—骨科学]