复杂型髋臼骨折手术治疗分析.docVIP

复杂型髋臼骨折的手术治疗分析 　　作者：王立飞,江亚,周思启,杨祖华　　作者单位：安徽省合肥市第三人民医院骨科 　　【摘要】 　目的：探讨复杂型髋臼骨折的手术治疗效果及方法。方法:对36例复杂髋臼骨折进行前方髂腹股沟入路、后方Kocher-langenbeck(K-L)入路或前后联合入路切开复位重建板内固定治疗。结果:患者均获随访, 时间18-48月，平均34月。无切口感染、深静脉栓塞、坐骨神经及股神经损伤等并发症发生。复位后X线片按Matta复位标准: ①解剖复位23例;②复位满意10例：③复位不满意3例，骨折均愈合。临床效果应用DAubigne and Postel评分标准[6]评价，优28例，良4例，可2例，差2例，优良率89%。发生创伤性关节炎8例，股骨头坏死1例，异位骨化2例。结论:应用切开复位重建板内固定治疗复杂髋臼骨折，可重建髋臼的稳定性，恢复髋臼关节面的平整和良好的头臼匹配关系，是治疗复杂髋臼骨折的有效方法。 　　【关键词】 髋臼骨折; 手 术; 内固定 　　Analysis of Surgical Treatment of Complex Acetabular Fractures 　　WANG Lifei, JIANG Ya, ZHOU Siqi, et al 　　(The Third Peoples Hospital of Hefei, Anhui Hefei 230022, China) 　　Abstract： Objective： To investigate the efficiency and method of complicated acetabular fractures treated with operative treatment. Method: 36 patients with complex acetabular fractures were treated with open reduction and reconstructive plate internal fixation by ilio-inguina, Kocher-Langenbeck(K-L) or combined ilio-inguinal and Kocher-langenbeck approaches . Result: All the 36 cases were followed up for 18-48 months, average 34 months, there was no complications such as cut infection, DVP , sciatic nerve and femoral nerve injury. According to Matta reduction system, anatomic reduction was obtained in 23 cases, satisfactory reduction in 10 cases and unsatisfactory reduction in 3 cases. According to modified dAubigne-postel score system, the clinical efficiency was excellent in 28 cases, good in 4, fair in 2, and poor in 2, fineness rate 89%. 8 was complicated with traumatic arthritis, 1 with femoral head necrosis, and 2 with heterotopic ossification. Conclusion: It is effective to treat complicated acetabular fractures with open reduction and reconstruction plate fixation .it can reconstruct the stability of acetabular, restore excellently the flattening of acetabular articular surface and better match relationship of femoral head and acetabular. 　　Key words: Acetabulum fractures; Operation; Internal fixation 　　髋臼骨折通常是由钝性的高能量冲击