复杂移位型髋臼骨折的临床研究

Clinical study of complex displaced acetabular fractures

目的 :探讨复杂移位型髋臼骨折的临床治疗效果。方法 :从 2 0 0 0年 2月 - 2 0 0 2年 7月收治2 3例髋臼骨折患者 ,其中后柱合并后壁骨折 11例 ,前柱合并后半横形骨折 6例 ,双柱骨折 5例 ,“T”形骨折 1例。本组复杂移位型髋臼骨折均采用手术治疗。手术采用髂腹股沟入路 11例 ,Kocher Langen beck(K L)入路 5例 ,髂骨股骨入路 4例 ,前后联合入路 3例。结果 :根据Matta评分标准 ,解剖复位 16例 (6 9 6 % ) ,满意复位 6例 (2 6 1% ) ,不满意复位 1例 (4 3% )。所有病例随访 6～ 2 6个月 ,平均 19 6个月 ,随访疗效与X线优良率分别为 81 8% ,83 9%。结论 :复杂移位型髋臼骨折尽早手术治疗可取得满意的骨折复位和临床疗效 ,手术医师的手术技巧和临床经验与疗效密切相关。

Objective:To inquire into the therapeutic effectiveness of treatment on complex displaced acetabular fractures.Methods:Twenty-three cases of complex type of acetabular fracture were treated from February 2000 to July 2002.Out of them,there were 11 cases with fracture in posterior column and wall;6 cases of fracture in anterior column and hemi-transverse;5 cases of fracture in both column and one case with T-shaped fracture.All 23 cases were treated with open reduction and internal fixation.Ilio-inguinal approach was adopted in 11 cases,Kocher-Langenbeck approach in 5 cases,and ilio-femoral approach in 4 cases,and double approach in 3 cases.Results:According to Matta's scores standard,16 cases(69.6%)had anatomical reduction,6 cases(26.1%)satisfactory reduction,1 case(4.3%)unsatisfactory reduction.All cases were followed up from 6 months to 26 months,with an average of 19.6 months.The clinical excellent and good rate for clinical and roentgenographic results were 81.8%,83.9% respectively.Conclusion:Early reduction of acetabular fractures is capable to get satisfactory reduction and clinical effectiveness.The surgical techniques and clinical experience are important factors for the clinical effectiveness.