对99例髋臼骨折内固定治疗的分析

Open Reduction and Internal Fixation for 99 Acetabular Fractures

从1972年11月到1994年3月,401例髋臼骨折病人中的99例经手术治疗并获随访,包括30例双柱骨折,13例横骨折伴后壁骨折,9例后壁骨折,9例后柱骨折,9例前往骨折伴前壁骨折,13例T形骨折和16例横骨折.平均随访时间为7年(2～14).外科手术入路的选择,后入路53次,髂腹股沟入路23次,延长的髂股骨入路11次,放射状入路9次和结合性入路6次.复位情况用X线平片来评判,解剖复位的有59例(59.6%),接近解剖复位(<2mm的错位)的有19例(19.2%).总结果用Harris Hip Score来评判,优秀的有53例(53.5%),良好的有25例(25.3%),一般的有14例(14.1%),差的有7例(7%).并发症中,有10例(53%)为感染,7例(37%)为静脉栓塞.这些结果表明,对于错位严重的髋臼骨折,切开复位内固定是一种可以选择的治疗方法.

Between November 1974 to March 1994. 401 patients with acetabular fractures, 99 of them were opera-tively treated available for followup. They included 30 both column. 13 transverse associated posterior wall. 9 posterior wall; 9 posterior column; 9 anterior cloumn associated anterior wall; 13 'T' shaped and 16 transverse fractures. The mean length of followup was 7 years (2-14). The surgical approaches chosen were Kocher - Langen-beck (53), ilioinguinal (23), extended iliofemoral (11), triradiate (9) and combined (6). Reduction were rated by plain radiography and considered anatomic in 59 (59. 6%) and near anatomic (<2mm displacement) in 19 (19. 2%). Overall outcome was rated using Harris hip score as excellent in 53 (53. 5%), good in 25 (25. 3%), fair in 14 (14. 1%), and poor in 7 (7%). There were 10 (53%) infections. 7 (37%) DVT. These results validates open reduction as the treatment of choice in most displaced fractures of the acetabulum.