移位髋臼骨折的内固定治疗

Treatment of displaced acetabular fracture with internal fixation

目的 :对移位髋臼骨折的分类、手术入路及内固定方法的选择进行探讨。方法 :对 2 6例按不同类型不同手术入路分别以拉力螺钉、可吸收螺钉、重建钢板作内固定治疗的髋臼骨折进行回顾性总结分析。结果 :2 2例经 1年至7年 ,平均 2 .7年随访。术后 1例出现坐骨神经损伤 ,半年后恢复 ;2例出现关节周围异位骨化 ,轻微疼痛 ,但不影响关节功能。未发生术后感染及股骨头坏死。 19例达到解剖复位 ,3例满意复位。参照美国矫形外科学会标准评估疗效 :优 16例 ,良 3例 ,可 2例 ,差 1例 ,优良率达 86 .3%。结论 :对移位髋臼骨折应积极创造条件进行手术治疗 ,正确的分型和手术入路选择是手术成功的关键 ,坚强而有效的内固定是早期功能训练和减少并发症的有力保证。

Objective:To discuss classification、surgical approach and method of internal fixation of displaced acetabular fracture.Methods:26 cases displaced acetabular fracture of different classification and surgical approach are treated respectively with tensile screws,absorbed screws and reconstructed plates,which was retrospectively analysed.Results:The following-up period of 22 cases lasted from one year to 7 years.1 case with sciatic neuralgia after operation were recovered after half a year;2 cases with heterotopic ossification had feeble pain,but not affected function of hip.No cases had infections and necroses of the femoral head after operation.19 cases obtained anatomy reduction;3 cases obtained satisfactory reduction.To evaluate in according to standard of orthopaedic academe of America:excellent(16 cases),good(3 cases) satisfactory(2 cases),poor(1 case).its ratio of excellence good was 86.3 %.Conclusion Displaced acetabular fracture need operating actively.Correct classification and surgical approach was key to success of operation.Strong and effective internal fixation was assurance of early functional and decreasing complication.