不同入路治疗复杂髋臼骨折的疗效探讨

Investigation of curative effects by different approaches in the treatment of complex acetabular fracture

目的本研究旨在对比分析不同手术入路治疗复杂髋臼骨折的临床疗效,为临床医生治疗复杂髋臼骨折提供可靠依据。方法对30例不同骨折分类的复杂髋臼骨折患者选择不同的手术入路进行治疗,对比分析不同手术入路患者的Matta影像学评分标准和Matta临床评分及并发症发生情况。结果扩展髂股入路组异位骨化发生率高于其他入路组,前后联合入路组Matta临床评分优良率为87.5%。手术的主要并发症主要包括异位骨化、创伤性关节炎、坐骨神经损伤等。结论对于髋臼骨折的治疗,应该依据患者骨折类型来选择最佳的手术入路方式,在单一常规切口不能充分显露骨折部位的情况下可以选择联合入路,降低手术并发症发生率,最大限度恢复髋关节功能。

Objective To comparatively analyze the clinical effects of different surgical approaches in the treatment of complex acetabular fracture, in order to provide reliable reference for treating complex acetabular fracture. Methods A total of 30 patients of complex acetabular fracture with different fracture classification received different surgical approaches for treatment. Comparisons were made on Matta imageing criteria, Matta clinical score, and complications in different approaches patients. Results Expanded iliofemoral approach group had higher incidence of heterotopic ossification than the other groups. Good rate of clinical score in anteriorposterior combined approach group was 87.5%. Main complications included heterotopic ossification, traumatic arthritis, and sciatic nerve injury. Conclusion The best approach in surgery should be chosen by fracture classification in the treatment of acetabular fracture. When conventional single incision cannot fully show fracture area, combined approaches is selectable for reducing incidence of complications and maximumly recovery hip joint function.