医学骨科论文 5).docVIP

手术治疗髋臼合并同侧股骨干骨折的临床研究 作者：王开明 杨德顺 廖亮 秦骥 张庆 作者单位：安徽省蚌埠市第三人民医院骨科，安徽 蚌埠 233000 【摘要】 目的 总结髋臼合并同侧股骨干骨折的手术方法和治疗效果。方法 从2003～2006年共手术治疗12 例。股骨干骨折根据AO的Müller分类法，A1型3 例，A2型2 例，A3型3 例，B2型3 例，C2型1 例。髋臼骨折按AO的Letournel2Judet分型，A1型2 例，A2型1 例，B型5 例，C型4 例。根据不同骨折类型，分别采用不同手术入路进行骨折复位内固定。结果 12 例患者平均随访15.8个月，根据Matta影像学评分，解剖复位7 例，满意复位3 例，不满意复位2 例。根据D′Aubigné和 Postel功能评分法，优6 例 50.00％ ，良2 例 16.67％ ，可3 例 25.00％ ，差1 例 8.33％ 。根据Epstein影像学标准评价，优7 例，良2 例，可2 例，差1 例。发生股骨头坏死合并创伤性关节炎1 例 8.33％ ，异位骨化1 例 8.33％ 。无手术死亡、感染及骨折不愈合发生。结论 把握合适的手术时机，准确的评估骨折类型，选择正确的手术入路，配合术中灵活的处理，是提高疗效的关键。 【关键词】 髋臼 股骨 骨折 外科 手术 治疗结果 Clinical Study of the Treatment of Lpsilateral Acetabular Fracture and Femoral Fracture WANG Kai2ming，YANG De2shun，LIAO Liang，et al Department of Orthopedica，the Third People′s Hospital of Bangbu in Anhui，Bangbu 233000，China Abstract：Objective To improve the effect of operative treatment of ipsilateral acetabular fractures and femoral fractures by analyzing the clinical experiences in the treatment of the fractures.Methods In this series，12 ipsilateral acetabular fractures and femoral fractures were reviewed.Femoral fractures were classified according to Müller classification.Of the 12 cases，fractures of A1 type were seen in 3 cases，A2 type in 2 cases，A3 type in 3 cases，B2 type in 3 cases，and C2 type in 1 case.Acetabular fractures were classified according to Letournel2Judet classification.In those cases，fractures of A1 type were seen in 2 cases，A2 type in 1 case，B type in 5 cases，and C type in 4 cases.Different approach and treatment were adopted in those cases according to the type of fractures.Results All the cases were followed up for average 15.8 months.According to criteria of Matta radiographic grade，there were 7 cases with anatomic reduction，3 with satisfactory reduction，and 2 with unsatisfactory reduction.Based on the D′Aubigné and Postel clinical grading system，6 50％ cases showed excellent results，2 16.67％ cases good，3 25％ cases fair and 1 8.33％ cases poor.According to criter