髋臼骨折合并坐骨神经损伤的治疗

Treatment for sciatic nerve injuries associated with acetabular fracture

目的:探讨髋臼骨折合并坐骨神经损伤患者的治疗方法及疗效。方法:对53例髋臼骨折合并坐骨神经损伤患者进行回顾性分析,其中39例行手术治疗,将骨折复位、固定,坐骨神经探查,神经松解减压或束膜吻合;14例行保守治疗,给予牵引,营养神经,理疗等。获得随访47例,手术组35例,保守治疗组12例。随访12个月~8年,平均2年。结果:坐骨神经损伤功能恢复情况根据MCRR标准,手术治疗组,优19例,良10例,一般5例,差1例;保守治疗组,优5例,良2例,一般3例,差2例。髋臼骨折复位程度按Matta标准,手术组解剖复位为21例,满意复位为14例,不满意复位0例;保守组解剖复位为2例,满意复位为6例,不满意复位4例。结论:髋臼骨折合并坐骨神经损伤者应早期手术,将骨折复位、固定,坐骨神经探查,神经松解减压或束膜吻合,可获得较好疗效。

Objective：To investigate the effect of treatment tor acetabular fractures complmateO wHn scmnc nerve injuries, zvlcutt, ua ：J,, cases of acetabular fractures complicated with sciatic nerve injuries were reviewed. 39 cases were treated by operation, the fracture were reducted and fixed with steel plates and screws, the sciatic nerves were neurolysis or nerve repair; 14 cases were treated with non surgical methods. 35 cases of surgical group and 12 cases of non surgical group were followed, The follow - up period lasted i＇rom ｜ year to 8 years with an average of 2 years. Results：The outcome of sciatic nerve was evaluated according to MCRR criteria, of 35 cases surgical group, 19 were excellent, 10 good, 5 i^tir, 1 poor; of 12 non surgical group, 5 excellent,2 good,3 fair,2 poor. ＇Fhe fractures were evaluated according to Matta criteria, of 35 cases surgical group,21 good,14 fair, 0 poor; Of 12 non surgical group, 2 good, 6 fair, 4 poor. Conclusion：Early reduction and fixation of the fractures and early exploration of the sciatic nerve and neurolysis or repairing of the injured sciatic nerve may contribute to good prognosis.