髋关节后脱位合并股骨头骨折的治疗探讨

Management of Posterior Dislocations Plus Fractures of the Femoral Heads

目的 :通过治疗 19例髋关节后脱位合并股骨头骨折就其治疗方法、手术入路及并发症进行探讨。方法 :1985～ 1988年 ,共收治此类损伤 19例 ,将其分为 4型 ,Ⅰ型 3例 ,Ⅱ型 6例 ,Ⅲ型 1例 ,Ⅳ型 9例 ,根据各类分型的不同创伤病理改变 ,对其采用不同的治疗方法。结果 :经最短 1年 ,最长 14年随访 ,19例中 ,疗效优 12例 ,良 2例 ,可 3例 ,差 2例 ,优良率为 74%。结论 :治疗效果的关键是对此类病的正确认识和处理 ,髋关节后侧切口是手术治疗的主要手术途径。并发症的出现与创伤的严重程度有关。

Objective: Studying treatment, approachs complications of posterior dislocations plus fractures of the femoral heads after 19 cases of management and consideration. Method: Classification was based on Pipkin's creteria. Of the 19 cases, 3 were type Ⅰ, 6 type Ⅱ, 1 type Ⅲ, 9 type Ⅳ. Various procedures were taken according to classifications and pathology. Result: Follow up study was 1 to 14 years. Of the 19 cases, excellent result was achieved in 12 cases, good in 2, fair in 3, poor in 2. Rate of excellent and good result was 74%. Couclusion: The key to better result achieved in this kind of patient was proper diagnosis and treatment. Posterior approach was the choice for operative success. Emerge of comlications was directly related with severity of the trauma.