采用单一改良K-L入路同时治疗髋臼双柱骨折

Surgical treatment anterior and posterior acetabular column fractures with single modified Kocher-Langenbeck(K-L) approach

目的回顾性分析髋臼双柱骨折患者,探讨采用单一改良K-L入路同时治疗髋臼双柱骨折方法。方法对12例髋臼骨折的患者采用单一改良K-L入路同时治疗髋臼双柱骨折,术后功能锻炼。结果随访6～27个月,按Matta标准评价髋臼复位质量:解剖复位7例,满意复位3例,不满意复位2例,优良率83.3%。髋关节功能参照改良的Merled,Aubigne标准:优6例,良3例,可1例,差2例,优良率75%。结论充分的术前计划、恰当的手术时机、充分的术野暴露以及良好的术后锻炼是治疗髋臼骨折的有效方法。

Objective To summarize retrospectively the clinical therapeutic and to investigate the treatment method of anterior and posterior acetabular column fractures with single modified Kocher-Langenbeck （K-L） approach. Methods From 2000,12 patients with anterior and posterio acetabular column fractures were treated by single modified Kocher-Langenbeck （K-L） approach and functional exercise after operation. Results All patients were followed up ranged from 6-27 months. According to Matta＇ s radiographic assessment system, the curative effect was anatomical in 7 patients,imperfect in 3 and poor in 2, the excellent and good rate was 83.3%. The functional outcome was measured by the modified Merle d,Aubigne score were：excellent in 6, good in 3, fair in 1 and poor in 2, the excellent and good rate was 75%. Conclusion Abundance operation plan, correct operation time, correct operative approach and functional exercise can improve therapeutic effects in serious acetabular fractures.