单切口配合拉力螺钉技术在复杂髋臼骨折中的应用

Single-incision with Lag Screw Technique in Complex Acetabular Fractures

目的:评价单切口配合拉力螺钉技术在复杂髋臼骨折中的应用。方法:2004年2月～2010年3月,收治31例复杂髋臼骨折患者。按Letournel的分类方法,双柱骨折19例,T形骨折8例,前方伴后方半横行4例。病例中21例行髂腹股沟入路,10例行Kocher-Langenbeck入路。结果:按Matta标准评价髋臼复位质量:解剖复位9例,满意复位16例,不满意复位6例,优良率80.6%。髋关节功能参照改良的Merled,Aubigne标准:优8例,良15例,可3例,差5例,优良率74.2%。并发症:坐骨神经损伤2例、创伤性关节炎2例、异位骨化2例,股动脉血栓1例。结论:单切口配合拉力螺钉技术创伤相对较小,固定满意,在处理复杂髋臼骨折中是一种可行的方法。

Objective：To summarize the single incision with lag screw in complex acetabular fractures.Methods：From February 2004 to March 2010,31 cases with complex acetabular fractures were treated.By Letournel classification,there were 19 cases of double-column fractures,8 cases of T-shaped fracture,and 4 cases of the front with the rear half rampage.Twenty-one cases received operation through routine ilioinguinal approach,and 10 cases through routine Kocher-Langenbeck approach.Results：Evaluation of reduction quality was based on Matta standards：9 cases obtained anatomical reduction.Satisfactory reduction was found in 16 cases,and dissatisfactory reduction in 6 cases.Total good rate was 80.6%.Hip function assessment was according to improved Merled,Aubigne criteria：excellent hip function recovery in 8 cases,good in 15 cases,fair in 3 cases and poor in 5 cases,with good rate 74.2%.There were 2 cases of sciatic nerve injury,2 cases of traumatic arthritis in,2 cases of heterotopic ossification,and 1 case of femoral artery thrombosis.Conclusion：Single-incision with lag screw causes relatively small trauma,and has satisfactory fixation in dealing with complex acetabular fractures.