新型H形解剖钛板治疗累及后壁/后柱髋臼骨折的疗效分析

Analysis of the effect of new H-shaped anatomical titanium plate for acetabular fracture involving pos-terior wall/posterior column

目的探讨累及后壁/后柱的髋臼骨折应用新型H形解剖钛板的效果。方法回顾性收集2014年1月至2019年6月收治的累及后壁/后柱的髋臼骨折患者130例,其中男性77例,女性53例,平均年龄(53.04±12.85)岁,包括试验组(新型H形解剖钛板固定)68例和对照组(常规解剖钢板固定)62例。比较两组手术情况和骨折愈合情况。通过Matta评估标准评定比较两组患者骨折复位情况,采用Harris髋关节功能评分评价比较两组髋关节功能恢复情况。随访并比较两组并发症发生率。结果130例患者获得满意随访,随访时间18个月。试验组平均骨折愈合时间[(14.85±1.12)w]短于对照组[(17.44±1.05)w](t=13.567,P<0.001);试验组术后1.5年Harris评分[(90.96±5.44)分]高于对照组[(85.62±3.75)分,t=6.455,P<0.001];Harris评分优良率(82.35%)高于对照组(59.67%,χ^(2)=8.190,P=0.004)。两组手术时间、术中出血量、解剖复位率,满意复位率、并发症发生率比较差异均无统计学意义(P>0.05)。结论累及后壁/后柱的髋臼骨折应用新型H形解剖钛板固定稳定,并发症少,骨折复位和愈合满意,髋关节功能恢复良好,是比较理想的手术方法。

Objective To investigate the effect of applying a new H-shaped anatomical titanium plate to acetabular fractures involving the posterior wall/posterior column.Methods From January 2014 to June 2019,130 patients with acetabular fractures involving posterior wall and posterior column were retro-spectively analyzed,including 77 males and 53 females with an average age of(53.04±12.85)years old,68 patients were divided in the experimental group(New H-shaped anatomical titanium plate fixation)and 62 patients in the control group(conventional anatomical plate fixation).of the two groups were compared.Patients were followed up and the rate of complications,operation index and fracture healing and hip function recovery between the two groups was compared.Results 130 patients were followed up for 18 months.The average fracture healing time of the experimental group was(14.85±1.12)weeks,which was shorter than(17.44±1.05)weeks of the control group(t=13.567,P<0.001).The Harris score and excellent and good rate of Harris score 1.5 years after operation of the experimental group washigher than the control group.There were no significant differences in operation time,intraoperative blood loss,anatomical reduction rate,satisfactory reduction rate and the rate of complications between two groups(P>0.05).Conclusion The new H-shaped anatomical titanium plate is an ideal surgical method for cetabular fracture involving the posterior wall/posterior column.