改良Letournel-Judet髋臼骨折分型在复杂髋臼骨折治疗中的应用

Improved Letournel-Judet Classification in Treatment of Complex Acetabular Fractures

目的：探讨改良Letournel-Judet分型在治疗复杂髋臼骨折的应用价值。方法：1998年9月～2006年10月,共治疗有完整随访资料459例改良Letournel-Judet分型复杂髋臼骨折,其中Ⅰ型82例,Ⅱ型14例,Ⅲ型162例,Ⅳ型201例。术前经X线、骨盆CT三维重建明确诊断分型后,分别采用前、后入路、前后联合入路及改良的髂股入路显露并复位,AO重建钢板内固定。结果：随访5～84月,平均36.3月,按Matta髋关节功能评定标准分析,优303例,良90例,可58例,差8例,优良率为85.6%。结论：改良Letournel-Judet分型是一种能为正确选择治疗方法和选择手术入路的髋臼骨折分型法,该分型简单、实用并能涵盖几乎所有复杂髋臼骨折。根据该骨折分型选择手术入路,复位内固定临床效果满意。

Objective： To investigate the practical value of improved Letournel--Judet classification in complex acetabular fractures. Methods.. From Sept. 1998 to Oct. 2006, 459 patients of complex acetabular fractures with complete follow--up data were classified according to improved Letournel--Judet classification. There were 82 cases belonging to type Ⅰ , 14 typeⅡ , 162 type Ⅲ and 201 type Ⅳ. Based on X--ray and the three--dimensional computed tomography, the patients respectively received operations with anterior, posterior, combined anterior--posterior and the improved iliofemoral approaches. All the fractures were fixed with screws and AO reconstruction plates. Results： All cases were followed up for 5 to 84 months, with an average time of 36.3 months. Under Matta criteria for hip joint function, results in 303 cases were rated as excellent, 90 cases as fine, 58 as fair and 8 as poor, with the excellent rate 85.6%. Conclusion： The improved Letournel--Jude classification system is simple and practical which can cover almost all complex acetabular fractures, providing correct choice of treatment and operative approach. Operative approach and internal fixation based on this classification system can achieve satisfied clinical results.