112例髋臼骨折手术治疗结果分析

Analysis of the result of operative treatment of 112 acetabular fractures

目的 通过对髋臼骨折手术治疗结果的分析和总结 ,以期进一步提高其治疗效果。方法 112例髋臼骨折患者 ,男 94例 ,女 18例 ;平均年龄 3 7.6岁。均按Letournel和Judet的髋臼骨折分类法进行分型 ;所有新鲜骨折受伤距手术的平均时间为 9.5d ;常用手术入路为Kocher-Lange nbeck入路、髂腹股沟入路和前后联合入路 ;采用专用器械及骨盆重建钢板和螺丝钉对骨折进行复位和固定。 结果 平均随访时间为 4 5 .7个月 ( 6～ 93个月 ) ,根据改良的Merled’Aubigne和Postel的髋臼骨折临床结果评分标准 ,本组优 3 5例 ,良 4 7例 ,一般 18例 ,差 12例 ,优良率为 73 .2 %。股骨头坏死 8例 ;无一例死亡、感染及不愈合。 结论 及时手术、解剖复位、早期功能锻炼。

Objective To improve the effect of operative treatment of acetabular fractures by analyzing the clinical experiences in the treatment of the fractures. Methods In this series, 112 acetabular fractures were reviewed and classified according to Letournel and Judet classification. The average duration between the time of injury and surgery was 9.5 days. Kocher Langenbeck,ilioinguinal and combined anterior and posterior approach were adopted. Fracture reduction and fixation were carried out with special instruments, pelvic reconstructive plates and screws. Results The average follow up period was 45.7 months (ranging from 6 to 93 months). Excellent results were found in 35 cases, good in 47, fair in 18, and poor in 12. The excellent and good rate was 73.2%. Avascular necrosis of the femoral head was found in 8 cases. Infection and non union were not found in this series and the mortality rate was 0. Conclusions Operation on time, anatomical reduction, early functional rehabilitation, surgeon's experience and active treatment of complications are the key points for reaching a good clinical result.