复杂髋臼骨折的手术治疗

Surgical Treatment of Associated Acetabular Fractures

目的探讨提高髋臼骨折复位质量的手术方法。方法自2005年3月至2010年3月,共手术治疗移位的复杂髋臼骨折26例,选择Kocher-langenbeck切口6例,髂腹股沟切口4例,扩大的髂股切口3例,前后联合切口13例。结果根据Matta提出的复位标准,本组解剖复位19例,良3例,差4例,复位优良率为84.6%(22/26);根据HHS(Har-ris hip score)疗效标准,所有26例中解剖复位组疗效优良率为84.2%(16/19),复位差组优良率为25%(1/4)。结论髋臼骨折的复位质量是决定手术疗效的关键,把握手术时机、正确选择切口、注意复位顺序、正确放置钢板并置入螺钉,是提高复位质量的关键。

Objective To explore the surgical methods for improving reduction quality of associated acetabular fractures.Methods From March 2005 to March 2010,26 cases with of associated displaced acetabular fractures were operated.Surgical types were as follows： 6 were operated with Kocher-langenbeck incision,4 with ilio-inguinal incision,3 with extended ilio-femoral incision,13 with combing posterior-anterior incision.Results According to Matta＇s reduction grade,the results were excellent in 19 cases,good in 3cases and poor in 4 cases,with choiceness rate of 84.6 %（22/26）.According to HHS（Harris hip score）,the choiceness rate was 84.2%（16/ 19） in the anatomical reduction group,and 25%（1/ 4） in the poor group.Conclusion The reduction quality is the key factor to the recovery of acetabular surgery.Suitable operative moment,proper incision,attention to reduction order as well as exactly implantation of the plate and screws are crucial for a high reduction quality.