难复的髋关节中心性脱位骨折手术治疗商榷

Operative Management of Difficult Reduction of Centeral Dislocation -fractures of the Hip

报告22例难复的髋关节中心脱位骨折,11例随访4年9个月,发生股骨头缺血环死或创伤性关节炎81.8%.作者在手术中观察到髋白骨折的移位、股骨头对髋臼的压迫作用和骨折、微骨折,提出髋关节中心性脱位骨折的分类方法.采用外固定架稳定头臼复位,髋臼骨折复位后植骨和钢板固定,术后六周用CPM良好的主被动功能训练,是取得良好疗效的重要条件.

A clinic and roentgenographic analysis of difficult reduction of 22 centeral dislocation - fractures of the hip is presented. According to the result of the following - up which averaged four years and nine monthes,the incidence rate of avascular necrosis of femoral head and traumatic arthritis of tne hip is 81. 8%. Authors observed the fractures displacement. the compression of femoral head on acetabulum and fracture or microfracture of femoral head. The classification of central dislocation - fractures of the hip is presented. The external fixation brace to re-tent reduction of the acetabulum and femoral head , bone grafting and internal fixation with plate and screws were adopted as operative reduction approaches. Authors consider that the technique associated active and passive functional motion of the hip joint which started from 6 weeks after surgery as well was an importent factor for good therapeatic results.