应用髋臼三维记忆内固定系统(ATMFS)治疗复杂性髋臼骨折及其临床意义  

Application of acetabular tridimensional memory fixation system (ATMFS) to treat complex acetabular fractures and its clinical significance

作　　者：张春才[1] 许硕贵[1] 禹宝庆[1] 徐卫东[1] 沈洪兴[1] 苏佳灿[1] 王家林[1] 纪方[1] 汪滋民[1] 王继芳[2] 王家让[3] 王爱民[4] 梁雨田[2] 沈惠良[5] 胡玉华 王振昊 李重茂[8] 陈宗和[9] 

机构地区：[1]第二军医大学长海医院骨科,上海市200433 [2]解放军总医院,北京市100853 [3]湖南省人民医院,长沙市410002 [4]第三军医大学大坪医院,重庆市400042 [5]北京宣武医院,北京市100053 [6]江苏省武警总队医院,江苏省扬州市225003 [7]解放军第一五三医院,郑州市450042 [8]解放军第一一三医院,浙江省宁波市315040 [9]江西省人民医院,南昌市330006

出　　处：《中华创伤骨科杂志》2004年第4期364-368,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探索髋臼三维记忆内固定系统(ATMFS)治疗复杂性髋臼骨折(CAF),恢复解剖头臼对应能力及与之对应的围手术期处理;为降低残疾,减少与避免中青年日后全髋置换提供经验。方法1997年8月～2003年2月ATMFS治疗CAF28例:新鲜15例,陈旧13例;新鲜与陈旧CAF重建解剖型髂骨臼后壁分别为3例与2例。结果所有使用ATMFS的CAF病例均有效固定于解剖位。随访8～63个月,平均11.8个月。15例新鲜CAF术后3.2个月患髋功能达健侧水平;11例陈旧CAF术后5.5个月达健侧水平。异位骨化2例,1例为BrookerⅣ型异位骨化,1例外展受限。结论ATMFS可用于治疗CAF,易使CAF有效固定于解剖位;其围手术期设计行之有效;优良率96.43%。同时,也在CAF与人工关节之间探辟了新径,降低残疾,减少与避免中青年全髋置换,提供了经验。Objective To discuss application of ATMFS and its perioperative management in treatment of complex acetabular fracture (CAF) and restoration of the anatomic correspondence of acetabulum and femoral head so that our experiences may help reduce disability rate and total hip replacement for young patients. Methods From August 1997 till February 2003, 28 cases of CAF, 15 fresh and 13 obsolete ones, were treated with ATMFS. Anatomic reconstruction of the posterior acetabular wall by ilium was performed in 3 fresh and 2 obsolete cases. All the cases were followed up for 8 to 63 months, averaging 11.8 months. Results No displacement observed in all the patients. It took 3.2 months for the hip joints to recover to their preoperative function in 15 fresh cases, and 5.5 months in 11 obsolete ones. Heterotopic ossification happened in 2 cases. One was Brooker Ⅳtype, and the other had limited abduction. According to the modified d'Aubigne and Postal Clinical Grading System, the good and excellent rate of hip function was 96.43%. Conclusions ATMFS is capable of treating CAF with our well designed perioperative management. This new method can achieve anatomic reconstruction of acetabulum and reduce the probability of total hip replacement.

关 键 词：复杂性髋臼骨折 三维记忆内固定系统 人工关节置换术 围手术期 腹膜后血肿 

分 类 号：R687.3[医药卫生—骨科学]