经改良髂腹股沟入路手术治疗髋臼骨折

Operative treatment of acetabulum fractures through modified ilioinguinal approach

目的:针对标准髂腹股沟入路的缺点进行改良。方法:1997年8月～2000年1月使用标准髂腹股沟入路治疗24例髋臼骨折,2000年2月～2003年11月使用改良髂腹股沟入路治疗35例髋臼骨折,记录每例的切口显露和关闭时间,术后常规拍X线片,对结果进行统计学检验。结果:标准和改良髂腹股沟入路组的切口显露时间(x±s)分别为(42.36±4.58)min和(29.64±3.19)min;切口关闭时间(x±s)分别为(52.42±6.64)min和(35.86±4.27)min。标准和改良髂腹股沟入路组达到解剖复位、复位欠佳和不满意复位的病例数分别为13、7、4例和29、4、2例。经统计学检验,P<0.05,差异具有显著性。结论:与标准髂腹股沟入路相比,改良髂腹股沟入路具有解剖相对简单、创伤小、手术时间短、显露充分、复位质量高、并发症少等优点。

Objective:To modify standard ilioinguinal approach according to its shortcoming. Methods:From August 1997 to January 2000, we treated 24 cases of acetabulum fractures through standard ilioinguinal approach. From February 2000 to November 2003, we treated 35 cases of acetabulum fractures through modified ilioinguinal approach. Approach exposure time and approach closure time of each patient was recorded, and each patient received post-operational X-ray radiograph. All results were taken statistical analysis. Results:Exposure time of standard and modified ilioinguinal approach group was 42.36±4.58 min and 29.64±3.19 min respectively; Closure time of standard and modified ilioinguinal approach group was 52.42±6.64 min and 35.86±4.27 min respectively. The number of fracture achieve anatomical reduction, imperfect reduction, unsatisfactory reduction of standard and modified ilioinguinal approach group was 13, 7, 4 , 29, 4 and 2 respectively. Statistical test showed difference significant. Conclusions:Compared with standard ilioinguinal approach, modified ilioinguinal approach has virture as follows: simple anatomy, low trauma, short operation time, sufficient exposure, excellent reduction and less complication.