前后联合入路治疗髋臼双柱骨折

Combined anterior and posterior approaches for the treatment of both-column acetabular fractures

目的探讨经前后联合入路手术治疗髋臼双柱骨折的临床疗效。方法对2006年1月～2009年6月间收治的19例髋臼双柱骨折病人行前后联合入路切开复位、重建钢板内固定手术。结果所有患者均获随访,随访时间12～36个月,平均27个月。骨折复位程度按照Matta标准:解剖复位14例,满意复位4例,不满意复位1例;髋关节功能采用改良Merled’ Aubigne-Postel髋关节评分标准:优9例,良7例,可2例,差1例,优良率为84.2%。术后并发症:创伤性关节炎2例;股骨头缺血性坏死1例,行人工全髋关节置换术。结论前后联合入路手术可使病人获得满意复位、牢固固定及早期功能锻炼,是治疗髋臼双柱骨折的有效方法。

Objective To evaluate the effects of combined anterior and posterior approaches for both-column acetabular fractures.Methods From January 2006 to June 2009,19 patients with bi-column acetabular fractures were treated by open reduction and reconstructive plates fixation using combined anterior and posterior approaches.Results All patients were followed up from 12 to 36 months with an average of 27 months.According to Matta＇s X-ray fracture reduction assessment,the results were excellent in 14 cases,good in 4 cases,and poor in 1 case.Using the modified Merle d＇Aubigne-Postel evaluation,the results were excellent in 9 cases,good in 7 cases,fair in 2 cases,and poor in 1 case with the excellent and good rate of 84.2%.Postoperative complications included 2 cases of traumatic arthritis and 1 case of femur head avascular necrosis,which underwent total hip replacement.Conclusion The procedure with combined anterior and posterior approaches is an effective method for bi-column acetabular fractures because it could achieve satisfactory reduction,solid fixation and early functional rehabilitation.