摘要
目的:探讨前后联合人路手术治疗复杂髋臼骨折的临床疗效。方法:分析2006年7月-2011年7月采用髂腹股沟入路联合kocher-langenbeck入路,切开复位重建钢板和螺钉固定治疗29例letournel&Judet分型复杂髋臼骨折患者的临床资料。结果:手术时间2~4h,平均(2.5±1.3)h,术中失血量400—900ml,平均(600±180)ml,无切口感染和血管神经损伤,出现深静脉栓塞3例,切口I期愈合,无内固定松动及断裂,骨折愈合时间2~4个月,随访时间8~48个月,出现异位骨化5例,股骨头坏死1例。按matta复位标准,解剖复位22例,满意复位6例,不满意复位1例。髋关节功能按d’Aubigne—postel评分系统评定,优22例,良4例,中2例,差1例。结论:前后联合人路切开复位重建钢板和螺钉固定具有骨折复位准确、固定牢固方便的优点,是治疗复杂髋臼骨折的理想方法之一 。
Objective : To investigate the surgical effect of complex acetabuiar fractures. Method : From July 2006 to July 2011, 29 cases with complex acetahular fractures(letournel and Judet classification) were treated with open reduction and reconstructive plate fixation by combined ilioinguinal approach and koeher-langenbeek approach, 19 males and 10 females with age from 22 to 59 years old. Result : The operation time was 2 to 4(2.5 + 1.3) hours, the intraoperative blood loss was 400 to 900(600 + 180)ml. No postoperative infection and vascular and nerve injury occurred, 3 case with deep vein thrombosis Were found and all wounds healed primarily, no loosening or breakage of screw, all cases got bony union in 2 to 4 months and were followed up for 8-48 months. Heterotopic ossification occurred in 5 cases and femoral head necrosis occurred in 1 case. According to Matta's reduction grade. There were anatomical reduction in 22 cases, satisfactory reduction in 6 cases and unsatisfactory reduction in 1 case. The function of hip was excellent in 22 cases, good in 4 cases, fair in 2 case and poor in 1 case, according to modified d' Aubigne-postel score system. Conclusion : it is ideal therapy for complex acetabular fracture through open reduction and reconstructive plate fixation by combined anterior and posterior approach.
出处
《中国医学创新》
CAS
2012年第21期22-24,共3页
Medical Innovation of China
关键词
髋臼骨折
重建钢板
骨折固定术
Acetabular fracture
Reconstructive plate
Fracture fixation