有移位髋臼骨折开放复位策略分析_医学论文.docVIP

有移位髋臼骨折开放复位策略分析_医学论文 有移位髋臼骨折开放复位策略分析_医学论文 【摘要】 探讨不同髋臼骨折的手术治疗方法。［方法］1995年1月～2006年3月对126例有移位髋臼骨折进行了开放复位内固定，其中，简单骨折61例，复杂骨折65例；陈旧性骨折14例，新鲜骨折112例。根据骨折复杂程度，首先处理关节腔内游离骨块，将负重区关节软骨下压缩骨折或翻转骨折复位，然后借助器械或手法矫正骨折端旋转或前后(内外)移位，最后解决分离移位，复位后采用重建钢板内固定。［结果］本组无死亡病例，术后解剖复位78例，满意复位42例，不满意复位6例。随访1～12年，髋关节功能优良率90.47％。［结论］不同的髋臼骨折须采取不同的开放复位策略，其选择决定于髋臼骨折的类型、移位方向及其相应的手术入路。 【关键词】 髋臼骨折 开放复位 手术治疗 Abstract：［Objective］To explore the surgical technique for the treatment of different acetabular fractures.［Method］Consecutive 126 cases with displaced acetabular fractures were undergone an open reduction and internal fixation at our hospital from January 1995 to March 2006. Of them, there were 61 cases with simple type of fractures, 65 cases with complicated type, and 14 cases with old fracture, 112 with fresh fracture. The following precedures were taken according to the fracture type, namely, free fracture fragments in the hip joint were first dealed with, compressed or reversed subcartilage fracture blocks in the weightbearing area of the joint should be reduced. By assistanee with some particular acetabular surgical instruments, the rotated or anterior/posterior (medial/lateral) displacement of the fracture was first reduced, then apart displacement of fracture was finally repositioned, and then fixed with reconstructed plate.［Result］No perioperative deaths occurred. After operation, anatomic reduction was achieved in 78 cases, good reduction in 42, incomplete reduction in 6. At a followup of 1 to 12 years, a excellent and good result was attained in 90.47% of the patients according to the American Academy of Orthopedic Surgeons (AAOS) score.［Conclusion］The different method of open reduction should be taken for different fracture of the acetabulum. The exact methods of the reduction are determined by the fracture type and its displacement direction as well as the operative approach. Key words：acetabular fracture open reduction surgical treatment 有移位的髋臼骨折是一种复杂的关节内损伤，外科手术因能最大限度地恢复关节的解剖结构、降低相关并发症的