髋臼骨折手术入路的选择与预后分析

Analysis of the Selection and Prognosis of Approach of Acetabulum Fracture

目的提高髋臼骨折的治疗质量,减少术后并发症。方法对65例髋臼骨折进行回顾性研究。结果按Matta评分法评价髋痛、行走及髋关节功能,经6个月～6年,平均3.3年48例55髋获得随访,其中非手术治疗14例14髋,优6髋,良4髋,可4髋,优良率71.4%;手术治疗34例41髋,优12髋,良19髋,可8髋,差2髋,优良率75%。结论髋臼骨折应力求解剖复位,并正确选择手术入路和内固定材料,提高手术技巧和解剖复位率,尽量减少剥离,合理的早期功能锻炼是防治移位髋臼骨折手术并发症的关键。

Objective To discuss the postsurgical complications. Methods pain, activity and funtion of the acetabulums were followed up ranged therapeutic effect of acetabulum fracture and reduce the occurrence of 65 cases of acetabulum fracture were reviewed. Results By evaluating the hipjoints according to the Matta＇s ranking system, 48 cases including 55 from 6 months to 6 years with the average of 3.3 years. 14 nonoperative cases including 14 acetabulums were classified as excellent in 6, good in 4, fair in 4. The excellent and good rate was 71.4%. 34 operative cases including 41 acetabulums were classified as excellent in 12 acetabulums, good in 19, fair in 8 and poor in 2. The excellent and good rate was 75%.Conolusion Acetabulum fracture should be repositioned as anatomic as possible. When operation is inevitable, selecting correct approaches and internal fixators, good operating ability, high rate of anatomic repositioning and reduction of stripping are very important. Suitable funtional exercises early in postsurgical period are important to preventing and treating the complications of displacing acetabulum fracture.