Magic钩板与四边体组合板治疗复杂髋臼骨折的疗效比较  

Comparison of the efficacy of acetabular magic hook plate and quadrilateral area combined plates in the treatment of complicated acetabular fractures

作　　者：陈嘉楠 陈开放 薛沛然 汤璐璐 郭晓东[1] Chen Jianan;Chen Kaifang;Xue Peiran;Tang Lulu;Guo Xiaodong(Department of Orthopaedics,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022

出　　处：《中华骨科杂志》2024年第12期817-824,共8页Chinese Journal of Orthopaedics

基　　金：国家自然科学基金(82072446,82202715,82272460)。

摘　　要：目的比较Magic钩板与四边体组合板治疗复杂髋臼骨折的疗效。方法回顾性分析2017年6月至2022年8月华中科技大学同济医学院附属协和医院骨科治疗的复杂髋臼骨折44例,其中21例采用Magic钩板内固定治疗(钩板组)、23例采用四边体组合板内固定治疗(组合板组)。钩板组男15例、女6例,年龄(43.1±11.8)岁。Letournel-Judet分型:双柱骨折13例、前柱伴后半横形骨折5例、"T"形骨折3例;侯氏三柱分型:B2.2型8例、C1型5例、C2型4例、C3型4例;髋臼四边体APQ分型:APQ1型15例、APQ2型6例。组合板组男16例、女7例,年龄(41.7±12.8)岁。Letournel-Judet分型:双柱骨折15例、前柱伴后半横形骨折6例、"T"形骨折2例;侯氏三柱分型:B2.2型8例、C1型6例、C2型4例、C3型5例;髋臼四边体APQ分型:APQ1型15例、APQ2型8例。比较两组手术时间、术中出血量、骨折愈合时间、Matta标准评估复位质量、改良Merle d'Aubign-Postel评分以及术后并发症。结果44例患者均获得随访,随访时间10~24个月,平均14个月。所有髋臼骨折均愈合,钩板组骨折愈合时间为(3.6±0.9)个月、组合板组为(3.7±0.9)个月,差异无统计学意义(t=0.549,P=0.586)。钩板组的手术时间为(138.3±30.7)min、术中出血量为(735.7±159.8)ml,组合板组分别为(163.9±48.7)min、(843.5±181.1)ml;两组手术时间和术中出血量的差异有统计学意义(P<0.05)。钩板组Matta标准评估复位质量,优13例、良5例、差3例,优良率为86%(18/21);组合板组优13例、良6例、差4例,优良率为83%(19/23);两组差异无统计学意义(χ^(2)=0.143,P=0.931)。术后3、6个月和末次随访时钩板组改良Merle d'Aubign-Postel评分分别为(13.8±2.2)分、(15.3±2.5)分和(16.7±1.8)分,组合板组分别为(13.1±1.9)分、(14.6±2.1)分和(16.4±2.0)分,组间差异均无统计学意义(P>0.05);但两组不同随访时点的差异均有统计学意义(F=9.658,P<0.001;F=16.195,P<0.001)。钩板组出现伤口脂肪液化�ObjectiveTo compare the efficacy of acetabular magic hook plates versus quadrilateral area combined plates in treating complicated acetabular fractures.MethodsA retrospective analysis was conducted on 44 cases of complicated acetabular fractures treated at the Department of Orthopaedics,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,from June 2017 to August 2022.Among these cases,21 were treated with magic hook plate internal fixation(hook plate group)and 23 with quadrilateral area combined plate internal fixation(combined plate group).In the hook plate group,there were 15 males and 6 females,with an average age of 43.1±11.8 years.According to the Letournel-Judet classification,there were 13 double-column fractures,5 anterior column with posterior semi-transverse fractures,and 3 T-type fractures.Additionally,8 cases were classified as B2.2 type,5 as C1 type,4 as C2 type,and 4 as C3 type;15 cases were APQ1 type and 6 were APQ2 type.In the combined plate group,there were 16 males and 7 females,with an average age of 41.7±12.8 years.This group included 15 double-column fractures,6 anterior column with posterior semi-transverse fractures,and 2 T-type fractures.Additionally,there were 8 cases of B2.2 type,6 cases of C1 type,4 cases of C2 type,and 5 cases of C3 type;15 cases were APQ1 type and 8 were APQ2 type.Comparative analyses included operative time,intraoperative blood loss,fracture healing time,Matta standard assessment,modified Merle d'Aubign-Postel scores,and postoperative complications.ResultsAll 44 patients were followed up for 10 to 24 months,with an average follow-up of 14 months.The acetabular fractures healed in all cases.The healing time was 3.6±0.9 months for the hook plate group and 3.7±0.9 months for the combined plate group,with no significant difference between the groups(t=0.549,P=0.586).The hook plate group had an operative time of 138.3±30.7 minutes and intraoperative blood loss of 735.7±159.8 ml,compared to 163.9±48.7 minutes and 843.5±181.1 ml,respe

关 键 词：髋臼 骨折 骨折固定术 内 四边体 

分 类 号：R687.3[医药卫生—骨科学]