髋关节后脱位合并髋臼后壁骨折的手术治疗

Experience of surgical treatment of dislocation of hip joint combined with acetabular posterior wall fractures

目的探讨髋关节后脱位合并髋臼后壁骨折手术疗效。方法总结31例髋臼骨折的手术治疗效果,手术采用K-L入路。复位后应用髋臼重建钢板、拉力螺钉内固定。结果平均随访时间为26个月(10-58个月)。复位根据Matta影像学评分,解剖复位16例,良好复位12例,差3例;优良率90.3%。结论髋臼骨折术前正确分析骨折类型,选择手术时机、手术顺序和术中良好的复位是提高治疗效果的关键。

Objective To discuss the method for management of acetabular fractures and evaluate the corresponding results.Methods The experience in treatment of 31 cases of acetabular posterior wall fractures was summarized.K-L（Kocher-Langenbeck） approach was applied in cases.Fixation was carried out with special instruments,such as acetabular reconstructive plates,lag screws.Results The average follow up time was 26 months（from 9 months to 57 months）.According to Matta evaluation,excellent 16 cases,good 12 cases,difference 3 cases.The excellentand good rate was 90.3%.Conclusion Correct analysis of the types of complicated acetabular posterior wall fractures,time selection of operation,reasonable surgical order and correct reduction are crucial factors for increasing the treatment rate.