扩展型髂股切口手术治疗复合型髋臼骨折_医学论文.docVIP

扩展型髂股切口手术治疗复合型髋臼骨折_医学论文 扩展型髂股切口手术治疗复合型髋臼骨折_医学论文 作者：陈石玉，朱小虎，罗建光，戚春潮 【摘要】 目的 探讨扩展型的髂股切口的优缺点和手术方法治疗复杂髋臼骨折的疗效。方法 回顾性总结了2002年至2005年收治的资料完整的手术治疗髋臼骨折26 例，按照Letournel分型：横行伴后壁骨折2 例，T型骨折8 例，前方伴后方半横行骨折3 例和完全双柱骨折13 例，均采用扩展型的髂股切口手术治疗，根据不同骨折类型采用重建钢板和拉力螺钉固定。结果 全部患者均得以随访，平均随访14个月，复位情况按Matta评分标准，解剖复位20 例，满意复位4 例，不满意复位2 例。髋关节功能参照Matta评分系统进行评估，优21 例，良2 例，一般2 例，差1 例。结论 手术治疗是复杂髋臼骨折的有效治疗方法，扩展型髂股入路对复杂髋臼骨折手术治疗是一个良好的选择。 【关键词】 髋臼骨折；手术治疗；扩展型的髂股入路 　　Extensile Acetabular Approach for the Surgical Treatment of the Complex Acetabular Fracture 　　Abstract：Objective To explore the advantages and disadvantages of extensile acetabular approach and discuss the effect of the surgical treatment of the complex acetabular fracture.Methods Twentysix patients with the complex acetabular fractures hospitalized from 20022005 were reviewed.According to LetournelJudet classification，there were 2 transverse and posterior wall fractures，8 T，3 anterior fractures accompanying posterior hemitransverse fractrures and 13 both column fractures.these patients were all treated through extensile acetabular approach.The reconstructive plates and compression screws were used for internal fixation basing on different classification.Results All cases were followed up by an average of 14 months.According to Matta criterion，20 cases were reduced anatomically，4 cases were reduced satisfactory，2 cases were poor.According to Matta evaluation，21 cases were excellent，2 cases were good，2 cases were fair and 1 case was poor.Conclusion Surgical treatment is effective for the treatment of the complex acetabular fracture，It is a good choice that the complex acetabular fracture is treated through extensile acetabular approach. 　　Key words：acetabular fracture；surgical treatment；extensile acetabular approach 　　髋臼骨折为高能量损伤所致，是一种复杂的骨折，尤其是波及双柱的复合型髋臼骨折，骨折移位更明显且更不稳定。这类骨折和其他关节内骨折一样需要尽可能的解剖复位，以最大限度恢复关节功能，降低创伤性关节炎、疼痛和功能障碍的发生率。近年来，髋臼骨折采用手术治疗越来越普遍，但由于髋关节周围结构复杂，肌肉丰富，特别是波及双柱的复合型髋臼骨折，手术显露比较困难，如何正确选择手术入路成为手术成功的关键。我们自2002年1月至2005年6月，用扩展型髂股切口手术治疗复合型髋