髋关节前脱位技术治疗髋臼骨折

Application of anterior surgical dislocation of hip joint in treatment of acetabular fractures

目的探讨手术中髋关节前脱位技术在治疗髋臼骨折中的应用价值。方法1999年8月-2001年12月，采用传统Koeher—Langenbeck（K—L）入路治疗36例髋臼骨折（组1）。2002年4月-2005年7月，采用髋关节后外侧入路及术中髋关节前脱位技术治疗32例髋臼骨折（组2）。两组随访时间7～35个月，平均24个月。结果采用髋关节前脱位技术（组2）骨折解剖复位率高于采用K—L入路（组1）；组1股骨头坏死率高于组2（P〈0．05）；组2关节功能优良率明显高于组1（P〈0．05）。结论与传统K—L入路相比，手术中采用髋关节前脱位技术具有显露髋关节充分、创伤小、手术时间短、复位质量高、并发症少等优点。

Objective To discuss value of anterior surgical hip dislocation technique in treatment of acetabular fracture. Methods A total of 36 cases with acetabular fracture were treated through traditional Kocher-Langenbeck approach from August 1999 to December 2001 （Group A） and 32 cases with acetabular fracture treated through anterior surgical dislocation from April 2002 to July 2005 （ Group B）. Both groups were followed up for 7-35 months （ mean 24 months）. Results Group B had higher rate of bone reduction than Group A. The rate of femoral head necrosis in Group B was lower than that in Group A （ P 〈 0.05 ）. The knee joint function in Group B was obviously better than that in Group A （ P 〈 0.05 ）. Conclusion Compared with standard K-L approach, anteiror surgical hip dislocation has advantages of sufficient exposure, minor trauma, short operation time, excellent reduction and less complication.