前后联合入路治疗复杂髋臼骨折

Treatment of complex acetabular fractures by anterior-posterior combined anterior and posterior approach

目的探讨前后联合入路治疗复杂髋臼骨折的临床疗效。方法采用髂腹股沟入路、联合K-L入路,切开复位重建钢板固定治疗21例复杂髋臼骨折患者。结果患者均获随访,时间10～36个月。切口均一期愈合,无血管、神经医源性损伤。按Matta复位标准:解剖复位18例,满意复位2例,不满意1例。骨折均愈合,愈合时间3～4.5个月。关节功能按d′Aubigne-Postel评分系统评定:优16例,良3例,可1例,差1例。出现股骨头坏死1例,异位骨化2例。结论前后联合入路、切开复位、重建钢板固定可明显提高复位质量,固定方便可靠,是治疗复杂髋臼骨折的有效方法。

Objective To investigate the efficacy of complicated acetabular fractures treated with open reduction by combined ilio-inguinal and Kocher-Langenbeck approaches. Methods 21 cases with complicated acetabular fractures were treated surgically by combined ilio-inguinal and Kocher-langenbeck approaches with reconstructive plate fixation. Results According to Matta reduction system, anatomic reduction was obtained in 18 cases, satisfactory reduction in 2 cases and unsatisfactory reduction in 1 case. All the 21 cases were followed up for 10 -36 months, average 16 months. All incisions healed primarily with no vascular and nerve injury. All got bony union in 3 - 4. 5 months. According to modified d＇Aubigne-postel score system, the function of hip was excellent in 16 cases, good in 3, fair in 1, and poor in 1. 1 was complicated with femoral head necrosis, and 1 with heterotopic ossification. Conclusions It is effective to treat complicated acetabular fractures with open reduction and reconstruction plate fixation by combined anterior and posterior approach.