髋关节后脱位合并髋臼后壁及股骨头骨折治疗

Treatment of dislocation of hip joint with acetabulum posterior wall fracture and the femur head fracture

[目的] 探讨髋关节后脱位合并后壁及股骨头骨折的诊断,手术治疗方法及影响预后的因素.[方法] 共36例患者,行手法复位术后, 2例行非手术治疗,患肢持续牵引,34例应用Kocher-langenback切口行手术治疗,髋臼及股骨头骨折复位内固定,结合牵引治疗.术中应用螺丝钉或钢板内固定髋臼后壁骨折,必要时植骨.螺丝钉固定股骨头骨折. [结果] 全部患者均随诊1～5年,根据相关资料评定:优26例,良6例,差4例. [结论] 髋关节的解剖复位可获得最佳得临床效果,手术内固定是最佳的治疗方法,骨折的良好复位及减少术中再损伤,保存残存血供是治疗此类损伤的关健.

[Objective] To investigate the diagnosis,operation ways and the agents of affect prognosi of disloca- tion of hip joint with acetabulum posterior wall fracture. [Methods] Among these thirty-six cases of patients, 2 cases were treated by maneuver repaired and affected extremities continuous traction, 34 cases were treated by open reduction, internal fixation the fracture of acetabulum posterior wall or femur head with screw or recon- struction steel and combined with traction after operation. [Results] With 1~5 years follow-up, 26 case were excellent, 6 good and 4 fair. [Conclution] Hip joint dissection reduction can obtain the best clinical effects.Op- eration internal fixation is the best treation way.The satisfactory replace can decrease the reinjuries and how to reserve the remain blood accommodation is the key of the treatment.