手术治疗髋臼骨折32例体会

Surgical management of acetabular fractures:a report of 32 cases

目的：探讨髋臼骨折手术治疗方法的选择。方法：手术治疗髋臼骨折32例,采用Kocher-Langenbeck（K-L）入路19例,髂腹股沟入路8例,前后联合入路复位5例,均采用国产重建钢板固定。结果：随访1-48个月,平均18.5个月。根据改良的Merled′Aubigine和Postel髋臼骨折临床结果评分标准,优15例,良10例,可5例,差2例,优良率78.1%。术后股骨头坏死6例,创伤性关节炎5例,坐骨神经损伤2例。结论：早期手术,选择正确的手术入路和稳定可靠的内固定是提高髋臼骨折治疗效果的关键。

Objective：To explore an effective surgical technique for management of acetabular fractures.Methods：Thirty-two cases of acetabular fractures were treated by surgical procedures.Nineteen cases were operated through Kocher-lengenbeck approach,8 cases ilioinguinal approach and 5 cases combined anterior and posterior approaches.All the cases were internally fixed with the reconstructive plate and screws.Results：All the cases were followed up for an average of 18.5 months（ranging from 1 to 48 months）.The function of the hip was evaluated by the mordified Merled＇ Aubigne and Postel score system.The results were excellent in 15 cases,good in 10 cases,fair in 5 and poor in 2.The total excellent and good rates were 78.1%.Avascular necrosis occurred in 6 cases,traumatic arthritis in 5 cases and sciatic nerve injury in 2 cases.Conclusions：Early operation,proper surgical approach and stable internal fixation are essential to the outcome of the hip function.