髋臼后壁骨折的手术治疗

Surgical treatment of fractures of the posterior wall of the acetabulum

目的探讨髋臼后壁骨折的手术治疗方法。方法手术治疗髋臼后壁骨折32例。经1～3年随访,根据术后骨折复位的质量、远期髋关节功能及X线片评定,对髋臼后壁骨折手术治疗效果进行分析。结果术后骨折复位的质量按Matta标准评定,解剖复位（移位≤1mm）31例,复位欠佳（移位2～3mm）1例。远期髋关节功能采用d′Aubigne6分法评分,优30例,良2例。X线片根据Epstein标准评定,优31例,良1例。结论髋臼后壁骨折手术治疗成功的关键在于及时准确的影像学诊断,严格的手术指征,解剖复位、坚强内固定、早期功能锻炼的治疗原则,对不同类型骨折的辨证施治。

Objective To investigate surgical treatment of the fractures of the posterior wall of the acetabulurn. Methods Surgical treatment of the fractures of the posterior wall of the acetabulum was performed in 32 patients and followed up for one to three years. The outcomes of the treatment were evaluated according to the quality of fracture reduction, long-term function of the hip joint, and X-ray features. Resualts According to Matta standard,anatomical reduction of the fractures with ≤1 mm deviation was seen in 31 cases and with 2-3 mm deviation in 1 case. d＇ Aubigne scoring showed an excellent long-term function of the hip joint in 30 cases,and good in 2 cases. The X-ray radiography Epstein＇s grading system showed excellent result in 31 cases, and good in 1 case. Conclusion The keys for succesfully treatment of the fractures of the posterior wall of the acetabulum are to have the accurate immaging diagnosis, strong operative indication, anatomical reduction, stable internal fixation, and early functional exercise, and to treat individually.