腹股沟入路治疗髋臼横型骨折17例体会

Experience of Treatment of 17 Cases of Acetabular Fracture through Ilioinguinal Approach

目的探讨髋臼横行骨折的手术治疗方法。方法选择2005年1月至2010年12月在宜都市第一人民医院行髂腹股沟入路手术治疗的17例髋臼横行骨折患者,均先行前路手术复位固定,术中C臂机透视,了解复位情况。复位好则结束手术,复位不满意则进行后路复位固定。结果该组患者均获得随访,随访时间为9个月至4.5年,平均21个月。骨折复位质量按Matta标准评定标准,优良率为88.2%,按美国矫形外科学会髋关节功能评价标准,优良率为76.5%,早期出现坐骨神经损伤1例,未出现感染、下肢深静脉栓塞、异位骨化,出现骨性关节炎3例。结论选择其手术入路是治疗的重要环节,决定手术入路的关键因素是骨折类型及其移位方向,决定功能恢复的是解剖复位的程度及手术的时间、合并伤及术后相关的并发症。

Objective To investigate the the surgical treatment for acetabular transverse fractures. Methods 17 cases of acetabular transverse fractures from Yidu First People; s Hospital during Jan. 2005 to Dec. 2010 treated by ilioinguinal surgical approach were selected, all of whom were first given anterior fixation, in-operation C-arm fluoroscopy to understand the fracture situation. In case of the satisfactory re- set,the operation was finished, in case of unsatisfactory reset, posterior fixation was done. Results Fol- low-up for 9 months to 4.5 years（ mean 21 months）were done. Quality of fracture reduction by Matta standards assessment：excellent rate 88.2%, American Orthopaedic Society hip function evaluation crite- ria： excellent rate 76.5% ;the early emergence of sciatic nerve injury in 1 case;no infection, deep vein thrombosis, heterotopic ossification;osteoarthritis in 3 patients. Conclusion Choosing surgical approach is an important part of treatment, a key factor determining the surgical approach is the fracture types and the shift direction, the functional recovery is determined by the anatomic degree and surgical time, as- soicated injuries and postoperative complications.