髋臼后壁骨折合并髋关节后脱位手术治疗的疗效分析

Analysis of surgical treatment for posterior wall fractures of acetabulum with hip posterior dislocation

目的评价髋臼后壁骨折合并髋关节后脱位手术治疗的临床效果,分析影响疗效的因素。方法回顾性研究33例髋臼后壁骨折伴髋关节后脱位手术治疗患者,术后进行影像学、髋关节功能评分等观察。结果所有患者随访6个月～2年6个月,平均22个月,骨折均骨性愈合。Matta影像学评分:优29例、良3例,差1例,优良率96%;关节功能Merled'Aubigné评分:优22例,良5例,尚可4例,差2例,优良率81.8%。本组患者未发生异位骨化、医源性坐骨神经损伤、股骨头坏死等并发症。结论髋臼后壁骨折伴髋关节后脱位早期切开复位内固定治疗能够取得比较良好的临床效果,且复位质量和功能康复可影响疗效。

Objective To evaluate clinical effects and analyse the factors affecting surgical results of operative treatment for posterior wall fractures of acetabular with hip posterior dislocation. Methods A retrospective study included 33 cases of poste- rior wall fractures of acetabular with hip posterior dislocation. Radiology and hip joint function evaluated the clitlical effects. Re- sults All cases were followed-up 22 month（ rang from 6 to 30）. Matta＇s score： excellent in 29 cases, good in 3 cases, bad in I cases. Merle d＇Aubign6 scores： 25 excellent, 4 good, 3 fair, 1 poor. There were no cases of heterotopie ossification, iatrogenic injuries of sciatic nerve and avascular necrosis of femoral head. Conclusion Early surgical treatment of posterior wall fi＇actures of acetabular with hip posterior dislocation relatede good clinical effects. But quality of reduction, functional rehabilitation ＂affected clinical results.