手术治疗髋臼后壁骨折伴股骨头脱位

Surgical treatment of acetabular posterior wall fracture with hip dislocation

目的探讨手术治疗髋臼后壁骨折伴股骨头脱位的临床疗效。方法18例髋臼后壁骨折伴股骨头脱位患者全部采用K-L入路复位钢板螺丝钉内固定治疗。结果手术时间60～120(90±30)min,失血量200～480(340±140)ml,18例均获随访,时间18～53(35.5±17.5)个月。采用Matta改良的d′Anbigne和Postel临床评价标准:优12例,良3例,可3例。结论髋臼后壁骨折伴股骨头脱位手术治疗可获得良好的临床效果,股骨头脱位复位越早越好,对伴有广泛粉碎性骨折者出现较差结果可能性更大。

Objective To investigate the clinical results of the surgical treatment of fractures of the aeetabular posterior wall with hip dislocation. Methods 18 cases of fractures of the aeetabular posterior wall with hip dislocation were treated with open reduction and internal fixation by plate and screws through K-L approach. Results The operation time averaged 60 - 120 （90 - 30 ） minutes, and blood loss measured 200 - 480 （ 340 ± 140 ） ml. Follow-up period was 18 - 53 （35.5 ±17.5 ）months. By the modified d＇ Aubigne clinical evaluation standard, 12 cases were excellent, 3 good and 3 fair. Conclusions Fractures of the acetabular posterior wall with hip dislocation can be repaired surgically with very good clinical resuhs. The sooner is the reduction of the dislocated hip, the better is the clinical outcome. It is more possible for those with comminuted fractures to have a poor clinical result.