复杂型髋臼骨折的手术治疗

Surgical Treatment of Complex Acetabular Fractures

目的探讨复杂型髋臼骨折的手术治疗效果,以提高髋臼骨折的诊疗水平。方法对38例复杂型髋臼骨折进行回顾分析,按Letournel-Judet分类,手术入路的选择以骨折类型为基础,分析骨折分类、手术入路、伤后手术时间、手术技巧、术后处理对骨折复位、髋关节功能恢复的影响。结果根据Matta评分,髋关节功能优异9例,良好18例,一般8例,差3例。6例发生不同程度的异位骨化,发生股骨头坏死3例,创伤性骨关节炎7例,下肢深静脉血栓2例。结论尽量早期手术,术前正确分析骨折类型,选择合适的手术入路,术中准确复位和妥善固定以及术后及早期关节活动是提高复杂型髋臼骨折疗效的关键。

Objective To explore the operative treatment of complex acetabular fractures to improve the diagnosis and treatment of acetabular fractures. Methods A retrospective analysis was made of 38 patients with complex acetabular fractures. The 38 cases were classified according to Letournel-Judet classification. The operative approaches were adopted according to different fractures. Results All cases were followed up for average 30 months（ 10 - 48 months）. According to Matta ratings, the hip function was excellent in 9 cases,good in 18 cases, general in 8 cases and poor in 3 cases. Varying degrees of heterotopic ossification occurred hi 6 cases,femoral head necrosis in 3 cases,traumatic osteoarthritis in 7 cases and deep venous thrombosis in 2 cases. Conclusion The correct classification of fractures before operation, appropriate surgical approaches, timely operation , complete reduction , stable fixation and early joint movement are important to the recovery of complex acetabular fractures.