腹直肌旁入路后柱通道螺钉治疗累及双柱复杂髋臼骨折效果分析  

Treatment of double column complex acetabular fractures with posterior column screws via pararectus approach the bypass of the rectus abdominis

作　　者：杨冬松[1] 王琼[1] 陈许冬 远东涛[1] 陈鹏[1] 凌建生 甄相周[1] 于蒙洋 Yang Dongsong;Wang Qiong;Chen Xudong;Yuan Dongtao;Chen Peng;Ling Jiansheng;Zhen Xiangzhou;Yu Mengyang(Dept of Orthopaedics,the Second Affiliated Hospital of Luohe Medical College,Luohe,Henan 462300,China)

机构地区：[1]漯河医学高等专科学校第二附属医院骨科,漯河462300

出　　处：《河南外科学杂志》2024年第6期1-3,共3页Henan Journal of Surgery

基　　金：河南省医学科技攻关项目(LHGJ20200885);河南省教育厅高等学校重点科研项目(24B320011);漯河医学高等专科学校创新能力提升项目(2019-LYZKYYB011)。

摘　　要：目的分析腹直肌旁入路后柱通道螺钉治疗累及双柱复杂髋臼骨折(AF)的效果。方法回顾性分析2019-01—2022-12漯河医学高等专科学校第二附属医院骨科行腹直肌旁入路后柱通道螺钉治疗的17例累及双柱复杂AF患者的临床资料。统计手术时间、术中出血量、骨折愈合情况,以及并发症发生率。术后随访12个月,末次随访,采用Matta法评价骨折复位质量,依据髋关节功能(Harris)量表评价髋关节功能。结果患者均成功完成腹直肌旁入路后柱通道螺钉手术。手术时间110.9 min(范围:90~150 min),术中出血量652.1 mL(范围:300~1000 mL)。均获骨性愈合,愈合时间12.7周(范围:9~16周)。术中腹膜破裂1例,即予以缝合;术后切口脂肪液化2例,经换药后愈合;下肢深静脉血栓形成2例,华法林抗凝治疗2个月血栓消失。末次随访,骨折复位质量优良率为82.4%,髋关节功能优良率为88.2%。结论腹直肌旁入路后柱螺钉治疗累及双柱复杂AF,通过一个切口即可完成髋臼前后柱骨折的良好复位与固定,创伤小,有利于髋关节功能恢复。Objective To evaluate the results of posterior column screws via pararectus approach for treatment of double column complex acetabular fractures.Methods A retrospective analysis of 17 cases with double column complex acetabular fractureswere treated with posterior column screws technique via pararectusl approach from Jan.2019 to Dec.2022.The operation time,intraoperative bleeding,fracture reduction quality,postoperative complications,time of fracture healing,and the functional recovery of the affected hip at the final follow-up according to Matta method was used to evaluate the quality of fracture reduction and hip function was evaluated on the hip function(Harris)scale.Results All patients successfully completed the posterior column passage screw procedure for the rectus paraapproach.The operation time was 110.9 min(range:90~150 min),and the intraoperative bleeding volume was 652.1 mL(range:300~1000 mL).Both were healed in bone for 12.7 weeks(range:9 to 16 weeks).1 case of intraoperative peritoneal rupture was sutured,2 cases of incision fat liquefaction after surgery,healed after dressing change,2 cases of lower limb deep vein thrombosis,and thrombosis disappeared in warfarin anticoagulant treatment for 2 months.At the last follow-up,the excellent rate of fracture reduction quality was 82.4%and that of hip function was 88.2%.Conclusion The para-rectus approach combined with posterior column screw technique for the treatment of acetabular fractures can achieve good reduction and fixation of the anterior and posterior column fractures through one incision,which is a minimally invasive operation with little trauma and is conducive to the recovery of hip function.

关 键 词：腹直肌旁入路 后柱 螺钉 双柱 髋臼骨折 

分 类 号：R683.3[医药卫生—骨科学]