经髂腹股沟入路治疗髋臼双柱骨折

Treating Both-column Fractures of Acetabulum via Ilioinguinal Approach

目的分析经髂腹股沟入路治疗髋臼双柱骨折的疗效。方法1999年1月至2003年1月经髂腹股沟入路治疗双柱骨折10例。按AO法分类C1型5例，C2型4例，C3型1例。术中先固定前柱骨折，再应用逆行拉力螺丝钉固定后柱骨折。结果解剖复位（移位小于等于1mm）7例，复位欠佳（移位小于等于3mm）3例。平均随访18．4（11～36）个月。根据改良的D^r Aubigne及Postel临床评定标准，优7例，良2例，可1例。结论经髂腹股沟入路治疗髋臼双柱骨折效果满意。经盆面逆行拉力螺丝钉固定后柱骨折是经髂腹股沟入路治疗双柱骨折的关键技术。

Objective To analysis the results of treating the both-column fractures of acetabulum via ilioinguinal approach. Methods 10 patients with both-column fracthre of acetabulum treated surgically via the single ilioinguinal approach from January 1999 to January 2003 were reviewed. According to AO classification,type C1 5 cases ,type C2 4 cases and type C3 1 case. After reduction and fixation of the fracture fragments of anterior column,the posterior fracture fragments of column were reduced using the quadrilateral surface and were fixed with two retrograde lag screws. Results The patients were followed up for an average of 18.4 months（range 11-36 months）. Fracture reduction were graded as anatomic （0 -1 mm displacement）in 7 cases, imperfect （2 - 3 mm displacement） in 3 cases, as determined by plain radiography. According to the modified Merled＇ Aubigne＆Postel hip score system,clinical outcome was graded as excellent in 7 patients,good in 2 and fair in one. Conclusion Treating the both-column fractures of acetabulum via ilioinguinal can obtain satisfactory clinical results. The key techniques are fixation of posterior column with retrograde interfragmentary lag screws.