髋臼骨折合并坐骨神经损伤的手术治疗

Operative treatment of acetabular fractures complicated with sciatic nerve injuries

目的 总结髋臼骨折合并坐骨神经损伤内固定和神经探查的手术治疗体会。方法 对 33例患者行重建钢板、拉力螺钉固定髋臼骨折 ,同时行坐骨神经探查术 ,神经损伤者予以神经松解减压或束膜吻合。结果 髋臼骨折复位程度按Matta标准 :解剖复位 14例 ,满意复位 16例 ,不满意复位 3例。坐骨神经功能恢复按MCRR标准评定 :优 15例 ,良 13例 ,可 3例 ,差 2例 ,优良率为 84 %。髋关节功能按修订的d’Aubigen Postel髋关节评分标准 :优 13例 ,良 13例 ,可 5例 ,差 2例 ,优良率为 79%。

Objective To review the operative treatment of internal fixation of acetabular fracture and the neurolysis for the associated sciatic nerve injury. Methods 33 patients were treated by operation, the fractures were reduced and fixed with reconstructive plates and screws, and the neurolysis about the sciatic nerve were performed. Results According to Matta score system, anatomic reduction was obtained in 14 cases, satisfactory reduction in 16 cases and poor reduction in 3 cases; According to MCRR score system, the functional results of sciatic nerve were found excellent in 15 cases, good in 13, fair in 3 and poor in 2, and the excellent and good rate was 84%. According to modified d'Aubigen and Postel hip score, the clinical outcomes were excellent in 13 cases, good in 13, fair in 5 and poor in 2, and the excellent and good rate was 79%. Conclusion The operative treatment of internal fixation provides satisfactory outcome for acetabular fracture complicated with sciatic nerve injury.