髋臼后壁骨折合并同侧股骨粗隆间骨折的治疗体会

Treatment of acetabular posterior wall fractures together with femoral intertrochanteric fractures

目的探讨髋臼后壁骨折合并同侧股骨粗隆间骨折的治疗方法。方法本组病例6例,均为车祸伤。未合并坐骨神经损伤。均采用Kocher-Langenbeck入路,内固定治疗。结果随访6-24个月,平均12个月,骨折全部愈合。优3例,良2例,尚可1例。结论髋臼后壁骨折合并同侧股骨粗隆间骨折为高能损伤,髋臼的处理尤为关键。可以通过Kocher-Langenbeck切口一次将两处骨折处理,术后要注意并发症特别是深静脉血栓的发生,还需对股骨头坏死进行长期的观察。

Objective To investigate the treatment of acetabular posterior wall fractures together with femoral intertrochanteric fractures.Methods Six patients suffered from traffic accidents,but no injury of sciatic nerve.Kocher-Langenbeck approach and inner fixation were performed in all patients.Results The patients were followed-up for 6-24 months,average 12 months.The fractures all healed.Three of them were excellent,2 good and 1 acceptable.Conclusion Treatment of acetabular posterior wall fractures is the key for patients with acetabular posterior wall fractures together with femoral intertrochanteric fractures.The patients should be treated at the two sites of fractures together through Kocher-Langenbeck incision,and the postoperative complication also should be paid attention to,especially the deep vein thrombosis.In addition,the symptoms of femoral head necrosis need to be monitored for long time.