三种手术入路治疗髋臼骨折临床分析.doc

三种手术入路治疗髋臼骨折临床分析[摘要] 目的:探讨三种手术入路治疗髋臼骨折的手术疗效。方法:采用Kocher-Langenbeck入路23例,髂腹股沟入路19例,前后联合入路4例。结果:患者全部得到随访,时间4～48个月。关节功能按D′ Aubigne和Postel 6分法评分标准评分,优27例,良16例,可3例,优良率为93.5%。4例出现创伤性关节炎,2例出现异位骨化,1例合并坐骨神经损伤者术后6个月恢复。结论:术前准确分析骨折类型,选择正确的手术入路,对骨折进行解剖复位,并采用有效内固定是提高手术疗效的关键。 [关键词] 髋臼骨折;Kocher-Langenbeck入路;髂腹股沟入路;前后联合入路 [中图分类号] R687.32 [文献标识码]B[文章编号]1673-7210(2010)03(a)-145-02 Clinical analysis of three surgical approaches for the treatment of acetabular fractures HUANG Ruoqiang1, LIU Youyu1, SUI Ying2 (1.Department of Orthopedics, the Central Hospital of Liaoyang City, China Medical University, Liaoyang 111000, China; 2.Department of Orthopedics, PetroChina Liaoyang Petrochemical Fiber Company Worker’s Hospital, Liaoyang 111003, China) [Abstract] Objective: To discuss the surgical treatment on acetabular fracture to shorten surgery time and hospitalization time. Methods: With the ways of Kocher-Langenbeck approach (23 cases), ilioinguinal approach (19 cases), Fore-after joint approach (4 cases). Results: All patients were followed up 4 to 48 months. According to the grade of joint function D’ Aubigne and Postel six forked method, execllence 27 cases, fine 16 cases, satisfied 3 cases, exellent rate was 93.5%. 4 cases with traumatic arthrophlogosis, 2 cases with heterotopic ossification, 1 case with ischiadic nerve injure was recovered in 6 months. Conclusion: It’s a challenge and test for doctors to treat complex acetabular fracture, so it should be run more cautiously and actively. The accurate analysis of the classification of fracture, correct operative approach and the fixation are the key to improve the efficacy of the surgical treatment. [Key words] Acetabular fractures; Kocher-Langenbeck approach; Ilioinguinal approach; Fore-after joint approach 髋臼骨折通常由高能量创伤引起,大多数髋臼骨折均需手术治疗,除开放伤和合并有髋关节脱位以外,一般不主张急诊手术,多数提倡应在伤后5～7 d手术,如超过2周,则由于血肿机化、软组织挛缩和随后的早期骨痂形成,均妨碍骨折的复位,并增加手术创伤。中国医科大学附属辽阳市中心医院2005年6月～2008年3月手术治疗髋臼骨折46例,取得了满意的临床效果。 1资料与方法 1.1一般资料 本组46例,其中,男32