移位髋臼横形骨折的诊断和治疗-中国科技论文在线.PDF

， 54o— ChineseJourealofO~thoaaedLc§．SeDtem[~er1996 临床研究 移位髋 臼横形骨折的诊断和治疗 R6 3te-z 孙俊英 唐天驷 洪天禄 董天华 A 摘要报告 l7例移位髋臼横形骨折 (下称 DTFA )的诊断和治疗 ，萁中单纯 DTFAll例．合并后壁骨 I折 6倒 。 采用Matta顶弧角临界值划分累及臼顶 f下rF)l2例 (10倒手术 2例因严重脑外伤束手术)：累及臼 窝(ITF)5例 (4倒骨牵引治疗．1例因台并后壁骨折手术)。陆访 l～5午 ．结果4例 ITF关节功能和x线表 现均优 良，手术治疗的1倒 ITF和 l0例 1TF优 良率82％．尚可 18％．非手术治疗的2例TrF均为差。表明 累及臼厦的DTFA应手术治疗 ．而祟及 臼窝者除合并后壁骨折外均可行保守洽疗，还表明Matta顶弧角对 于划分 臼顶和臼窝区的DTFA．决定是否手术治疗具有重要意义 作者认为 DTFA的诊断应得 x线摄片与 CT诊断相结合 ，手术人路应根据骨折移位方向选用前、后或权人路 ．复位应采用特制复位钳 ．固定应采用 孤形髋 臼骨折钢板 ，并避免广泛骨膜下剥离 ，减少异位骨化 ．方可获得理想疗效。 关键诃 髋 臼横形骨折 诊断 治疗 DiagnosisandTreatmentofDisplaced]~*811sveiseFracturesoftheAcetahulum SunJunying，TangTian- si，舶 呵 Tiardu，eta1．DepartmeraofOnhopaed~s，TheF~rstAffiliated ofSuzhouMedicalCollege， Suzhou P』50嘶 Abstract SeventeencasesofdisplacedtransversefracturesoftheacetahuluIi1fDTFA)werereviewed The diagnosiswasestablishedaccordingtoLetournel’8classificationandCTstartdard Thef~aetureswereelassifiedin． totranstectumfracture(TTF．12csses)andinfratectumfracture([TF，5cases)basedonMalta’smeasurement method FourofITFandtwoof|rrFweretreatedconservatively．oneITFassociatedwithposteriorwallfracture (PWF)and10Y[Fweretreatedsurgically Iheaveragefollov,-upwas3yeors FourofITFtreatedconservatively had excellentresultboth clinicallyand radiographicaily Eleven treated surgicallymade an excellentrate of 82％ ．fairrateofl8％ ．_rWoofITFtreatedconservativelyhad poorresults Theaul【IorsConcludedthatDTFA shouldbetreatedsurgica~y．whitet}c【casesassociatedwit}【PWFshouldhetreatedconservatively．TheMatm ’s measurementisimpo rtantfordecidingwhetherornottheweight-beatingdomeisinvolvedandwhetheror notan openreductionandinternalfixafonisindicated ThecombinedCTandconventionalradiographvisvaluabletoeft- tablishthediagnosis0fDTFA．Surgicalapproachesshouldbeselectedaccording tothedisplae