髋臼骨折手术入路选择策略

Selection of surgical approaches for acetabular fractures

髋臼骨折的损伤机制为股骨头撞击髋臼导致的髋臼骨性结构破坏,手术目的是重建髋关节的头臼匹配关系并维持稳定。由于髋关节的特殊解剖结构,股骨头的遮挡使其前后面不能相互照应,因此手术入路的选择关系到手术区域显露、骨折复位质量、固定效果,直接影响手术疗效;合理的手术入路选择在手术时间、术中出血、手术创伤及手术并发症等方面均有较大优势。髋臼骨折的手术入路包括前方入路和后方入路,但由于髋关节的解剖复杂性及髋臼骨折的多样性,没有一种手术入路能完成所有类型的髋臼骨折手术。笔者阐述多种手术入路的解剖特点及适应证、手术入路选择策略,为临床医师处理髋臼骨折提供参考。

The mechanism of injury of acetabular fractures is the bone structure damage caused by the impact of the femoral head.Surgical treatment of acetabular fracture aims to match the femoral head in exact congruence with the acetabulum and maintain joint stability.Due to the special anatomical structure of the hip joint and the occlusion of the femoral head,the selection of surgical approach is related to the surgical field as well as the quality of reduction and fixation,thus directly affecting the.clinical efficacy.An appropriate surgical approach has great advantages in reducing operation time,intraoperative bleeding,trauma and complications.Typical approaches for acetabular fractures include anterior approaches and posterior approaches.However,each approach has its own indlications and its not capable of treating all acetabular fractures due to the anatomical complexity of the hip joint and the diversity of the fractures.The author explores the anatomical characteristics,indications,and the selection strategies of various surgical approaches,s0 as to provide a reference for cdlinicians to deal with acetabular fractures.