经腹直肌旁入路治疗髋臼骨折

The lateral-rectus approach in the treatment of acetabular fractures

目的探讨经腹直肌旁入路治疗髋臼骨折的疗效。方法采用经腹直肌旁入路手术治疗35例髋臼骨折患者。末次随访时,按Matta标准评价骨折复位质量,采用改良Merle d′Aubigne和Postel评分标准评价临床功能。结果患者均获得随访,时间6~49个月。末次随访时,按Matta标准评价髋臼复位质量:解剖复位25例,满意复位9例,复位差1例;采用改良Merle d′Aubigne和Postel评分标准评价临床功能:优23例,良10例,中2例。无切口感染、异位骨化及血管、神经损伤等并发症发生。结论经腹直肌旁入路治疗髋臼骨折,具有手术创伤小、视野广、骨折复位和固定好、并发症少、术后功能恢复好的优点,临床疗效满意。

Objective To investigate the clinical effect of operative treatment of acetabular fractures with the lateral-rectus approach.Methods The 35 patients with acetabular fractures were treated by using lateral-rectus approach.At the last follow-up,fracture reduction was evaluated by Matta score system and the clinical outcome was evaluated by modified Merle d′Aubigne and Postel score system.Results All patients were followed up for 6~49 months.At the last follow-up,the fracture reduction was evaluated according to the Matta score system:anatomical reduction was obtained in 25 cases,satisfactory reduction was obtained in 9,poor reduction in 1.Clinical results were excellent in 23 patients,good in 10 patients,fair in 2 patients,according to modified Merle d′Aubigne and Postel score system.There were no incision infections,significant heterotopic ossification,blood vessel or nerve injury in the follow-ups.Conclusions Lateral-retus approach for the treatment of acetabular fractures can get satisfied exposure,large visual field,easy reduction and fixation,which can achieve a satisfactory clinical function for acetabular fracture.