髋臼骨折的手术治疗

Surgical Treatment for Acetabular Fractures

目的探讨髋臼骨折手术治疗方法和效果。方法笔者手术治疗髋臼骨折95例。手术采用K-L入路52例,髂腹股沟入路34例,前后联合入路6例,髂股入路3例。结果根据Matta影像学复位标准:解剖复位65例,良好复位23例,差4例,关节轮廓复位3例。所有病例随访1～6年,根据Merled’Aubigne的临床评定标准:临床疗效优良率80%(76/95),解剖复位和非解剖复位的临床优良率分别为92%(60/65)和53%(16/30)。两组比较差异具有非常显著性意义(χ2=19.5,P<0.01)。结论正确选择手术时机、切口入路、手术顺序和内固定植入位置是提高复位质量的关键。

Objective To investigate the method and result for the operative treatment of acetabular fractures. Methods Ninety - five patients with acetabular fracture were treated operatively from June 1998 to December 2005. The Kocher- Langenbeck （K- L） approach was applied in 52 patients, the ilioinguinal approach in 34, anterior combined posterior approach in 6 and the iliofemoral approach in 3. Results According to the reduction criteria of Matta radiography, there were 65 patients with anatomic reduction, 23 with satisfactory reduction, 4 with poor reduction, 3 with joint contour reduction. The follow- up ranged from 1 year to 6 years, averaged 3.5 years. According to the Merle d＇ Aubigne clinical criteria, the total excellence rate of clinical result was 80% （76/95）, with the excellence rate 92 96 （60/65） and 53 96 （16/30） in anatomic and non- anatomic reduction groups respectively, with a very significant difference （χ^2 = 19.5, P〈 0.01）. Conclusion It is crucial for a high reduction quality to select the right operation time, the proper incision approach, the operative procedure and the implantation position of the internal fixation.