髋臼骨折的内固定治疗

Operative Treatment of Acetabular Fracture

目的 探讨髋臼骨折内固定治疗方法。方法 总结 1999年 6月至 2 0 0 3年 5月 38例有移位的髋臼骨折进行内固定治疗的经验。所有骨折均按 L etournel- Judet的方法分型。根据骨折类型的不同 ,分别采用 Kocher-L angenbeck入路和髂腹股沟入路进行骨折复位 ,以骨盆重建钢板和螺丝钉进行固定。结果 38例患者平均随访时间2 .6 a。根据美国矫形外科研究院评价标准 ,优 32例 (84 .2 % ) ,良 4例 (10 .5 % ) ,可 2例 (5 .3% )。 3例并发股骨头坏死。无切口及深部感染 ,无内固定物折断。结论 正确分析骨折类型、选择恰当的手术入路、牢固的内固定和早期功能锻炼是提高髋臼骨折疗效的关键。

Objective To investigate the operative management of acetabular fractures. Methods 38 cases of acetabular fractures treated operatively from June 1999 to May 2003 were reviewed. All the fractures were classified according to the Letournel-Judet standard. The kocher langenbeck approach and ilioinguinal approach were used according to different fracture types. Reconstruction plates and screws were used for fixation. Results All cases were followed up for average of 2.6 years. According to the USA orthopaedic institution′s standard,32 cases were excellent(84.2 %),4 cases good(10.5 %),2 cases fair(5.3 %). 3 cases were found with the necrosis of fermoral head. No infection and internal fixation broken were found in 38 cases. Conclusions Correct analysis of the fracture types before operation,reasonable surgical approach,stable fixation and early exercise are essential for the treatment of acetabular fractures.