复合型髋臼骨折治疗的临床研究

Clinical study of the treatment of complex acetabular fracture (attached with a report of 58 cases)

目的 :探讨采用手术方法治疗复合型髋臼骨折的疗效。方法 :回顾分析 5 8例患者 ,按Le tournel分类 ,后壁伴后柱骨折 15例 ,横形伴后壁骨折 17例 ,T型骨折 6例 ,双柱骨折 12例 ,前柱骨折伴后半横形骨折 8例。根据不同的骨折类型 ,选择髂腹股沟入路 7例 ,Kocher Langenbech入路 9例 ,联合入路 31例 ,延长髂股入路 11例 ,全部采用重建钢板进行固定。结果 :5 8例患者 ,平均随访时间 14 6个月 ,根据Matta评分 ,优 4 1例 ,良 9例 ,可 7例 ,差 1例。异位骨化 3例 ,中重度创伤性关节炎 2例 ,股骨头坏死 1例 ,骨折块有移位 2例。结论 :术前正确分析骨折类型 ,选择合适的手术入路及及时的手术是提高髋臼骨折治疗效果的关键。

Objective: To explore the effect of the surgical treatment for the complex acetabular fracture. Methods: A retrospective analysis of 58 patients was performed.All the patients were classified according to the Letournel rules.Posterior wall and posterior column fracture 15,transverse and posterior wall frcture 17,T type frature 6,both columns fracture 12,anterior column and posterior transverse fracture 8.The choice of surgical approach was basesd on the individual fracture which including ilioinguinal approach 7,Kocher Langenbech approach 9,combined approach 31,extended iliofemoral approach 11.All the patients were fixed with reconstruction plates. Results: The average followed time was 14 6 months.The results were assessed by Matta scores,excellent 41,good 9,fair 7,poor 1.The rate of excellent and good was 86%.The heterotopic ossification 3,medium and severe traumatic arthritis 2,femoral head necrosis 1,displaced fracture fragment 2. Conclusion: The key to increase the effectiveness of surgical treatment of acetabular fracture is followed with the correct preoperative classification of the facture,the choice of appropriate surgical approach and time.