重建钢板联合可吸收螺钉治疗髋臼骨折的临床应用

Treatment of Acetabular Fractures with Pelvic Reconstruction Plates and Absorbable Screws

目的探讨重建钢板联合可吸收螺钉治疗髋臼骨折的可行性及临床效果。方法对2000年1月-2005年12月收治的24例髋臼骨折患者按照Letournel分类：T形骨折5例,后柱骨折4例,后柱并后壁骨折3例,后壁并横行骨折4例,前柱骨折2例,前柱并横行骨折3例,双柱骨折2例,双柱及前后壁骨折1例。根据骨折类型分别采用单一或联合髂腹股沟入路、髋臼后侧入路,行重建钢板联合可吸收螺钉内固定治疗。结果本组患者骨折复位质量按照Matta的评分标准,22例达到解剖复位,2例复位欠佳。所有患者获得8-24个月（平均14个月）随访,采用Modified d’Aubugneand Postal功能评定标准：优17例,良5例,可2例,优良率为91.7%。本组有2例发生创伤性关节炎,未见异位骨化发生。结论术前骨折的明确分类、合适入路的选择、满意的解剖复位及可靠的内固定是治疗髋臼骨折的关键,采用重建钢板联合可吸收螺钉的内固定方式是一种有效的治疗方法。

Objective To explore the feasibility and clinical effects of pelvic reconstruction plates and absorbable screws in treatment of complex acetabular fracture. Methods From January 2000 to December 200.5, 24 patients with acetabular fractures were treated with pelvic reconstruction plates and absorbable screws. The preoperative diagnosis of the patients revealed T shaped fracture in .5, posterior column fracture in 4, posterior column and wall fractures in 3, transverse and posterior wall fracture in 4, anterior column fracture in 2, anterior column and transverse fracture in 3, double column fracture in 2, and double column fracture and double wall fractures in l. According to the Letournel＇s classification, single or combined ilioinguinal or Kocher Langenbeck approaches were adopted depending on the fracture classification of the patient. Results After 8- 24 - month follow up （averaged 14 month）, according to the Matta criteria, 22 patients got anatomic reduction and 2 were unsatisfactory reduction. Based on Modified d＇ Aubigne and Postal Evaluation System, 17 patients achieved excellent results, .5 good, and 2 fair. The rate of good to excellent results was 91.7 %. Traumatic arthritis occurred in 2 patients, no heterotopic ossification was occurred. Conclusion Internal fixation with pelvic reconstruction plates and absorbable screws is an effective way to treat complex acetabular fractures.