摘要
目的 探讨髋臼骨折合并坐骨神经损伤的创伤机制及治疗。方法 分析本组髋臼骨折合并坐骨神经损伤共 2 0例 ,均行肌电图检查。 4例采用患肢持续股骨髁上牵引非手术治疗 ;16例采用髋臼骨折切开复位内固定手术治疗 ,术中视坐骨神经损伤程度作神经外膜松解或束间松解。结果 坐骨神经恢复情况 :优 7例 ,良 6例 ,可 4例 ,差 3例。结论 应根据临床检查 ,X线及CT所示骨折移位情况和有无髋关节后脱位 ,作电生理检查 ,结合临床有无造成神经严重损伤的因素而决定是否探查坐骨神经 ;术中肉眼观察坐骨神经损伤程度对指导手术和判断预后有一定意义 。
Objective To investigate the mechanism and treatment of injuries of the sciatic nerve associated with displaced acetabular fracture.Methods The clinical characters of the 20 patient with the injuries of the sciatic nerve were observed.Electromyography was used in the localization and determination of the severity of the injury in all cases.Among them 4 cases were treated by conservative treatment with skeletal traction,16 cases were operated with open reduction,internal fixation of the acetabular fracture and with neurolysis according to the appearance of the nerve at the operation.Results The occurrence of excellent nerve recovery was 7 cases,fair recovery was 6 cases,poor recovery was 4 cases ,bad recovery was 3 cases.Conclusion Open reduction and internal fixation combined with nerve exploration and neurolysis should be done according to the examination,the degree of fracture displacement depicted by roentgenogram and computed tomography.The type of lesion observed in the nerve intraoperatively may be important for prognosis.
出处
《骨与关节损伤杂志》
2004年第11期727-729,共3页
The Journal of Bone and Joint Injury
