改良Gibson入路治疗髋臼骨折

Modified Gibson approach for the treatment of acetabular fracture

目的 :针对Kocher Langenbeck入路的缺点设计改良Gibson入路 ,并探讨改良Gibson入路的优点。方法 :1994年 6月 - 1999年 2月使用Kocher Langenbeck入路治疗 36例髋臼骨折。1999年 3月 - 2 0 0 3年 12月使用改良Gibson入路治疗 32例髋臼骨折。结果 :Kocher Langenbeck入路组达到解剖复位 2 9例 ,复位欠佳 4例 ,不满意复位 3例 ;改良Gibson入路组达到解剖复位 2 8例 ,复位欠佳 3例 ,不满意复位 1例。经统计学检验 ,差异具有显著性 (P <0 0 5 ) ,改良Gibson入路组的骨折解剖复位率明显高于Kocher Langenbeck入路组。Kocher Langenbeck入路组关节功能表现优良者 30例 ,可3例 ,差 3例 ;改良Gibson入路组关节功能表现优良者 2 9例 ,可 2例 ,差 1例。经统计学检验 ,差异具有显著性 (P <0 0 5 ) ,改良Gibson入路组关节功能的优良率明显高于Kocher Langenbeck入路组。 结论 :与Kocher Langenbeck入路相比 ,改良Gibson入路具有显露充分、创伤小、手术时间短、复位质量高、并发症少等优点 ,可以替代Kocher Langenbeck入路。

Objective: Based on the shortcoming of Kocher Langenbeck approach,modified Gibson approach for the treatment of acetabular fracture was designed and its advantages was explored. Methods: From June 1994 to February 1999,36 patients with acetabular fracture were treated through Kocher Langenbeck approach.From March 1999 to December 2003,32 patients with acetabular fracture were treated through modified Gibson approach. Results: Anatomical reduction 29 patients,imperfect reduction 4,unsatisfactory reduction 3 in the Kocher Langenbeck approach group;Anatomical reduction 28,imperfect reduction 3,unsatisfactory reduction 1 in the modified Gibson approach group.There was statistically significant difference between Kocher Langenbeck approach group and modified Gibson approach group( P <0 05).The rate of anatomical reduction in the modified Gibson approach group was more than that of Kocher Langenbeck approach group obviously.Evaluation of joint function:30 with excellent and good,3 fair,3 poor in the Kocher Langenbeck approach group.Twenty nine patients with excellent and good,2 fair,1 poor in the modified Gibson approach group.There was statistically significant difference between Kocher Langenbeck approach group and modified Gibson approach group( P< 0 05).Excellent and good rate of joint function in modified Gibson approach group was more obviously than that in Kocher Langenbeck approach group . Conclusion: Compared with Kocher Langenbeck approach,the advantages of modified Gibson approach are as follows:sufficient exposure,small trauma,short operation time,excellent reduction and less complication,so it can be substitute for Kocher Langenbeck approach.