摘要
目的 :探讨髋臼骨折的分类、治疗方法与临床疗效的关系。方法 :从 1993年 6月至 2 0 0 2年7月 ,共收治 5 1例髋臼骨折患者 ,其中 30例髋臼骨折采用骨牵引治疗 ,牵引时间为 4～ 6周 ,3个月后开始负重 ;2 1例采用切开复位内固定 ,术前均作骨牵引 ,术后鼓励活动肌肉和关节 ,结合使用CPM机进行持续被动功能活动 ,2～ 3个月开始逐渐负重。结果 :4 4例获 1 5～ 10年随访 ,其中骨牵引治疗组 2 5例 ,手术治疗组 19例。疗效评定参照美国矫形外科学会提出的髋关节功能评价方法 ,采用非手术治疗组疗效优 11例 ,良 8例 ,可 2例 ,差 4例 ;采用手术治疗组疗效优 10例 ,良 6例 ,可 1例 ,差 2例。结论 :Le tournel分类中只有单纯的前后壁或前后柱骨折 ,骨折块小而未累及髋臼负重区的骨折 ,分离移位<3mm ,才适用牵引治疗 ;而对于复杂的髋臼骨折或分离移位 >3mm的单纯性骨折 ,只有应用手术治疗才可能有效恢复髋臼与股骨头的对合 ,提高临床疗效。
Objective: To study relations of clinical effects with the classification and the choice of therapy in the acetabular fractures. Methods: From June 1993 to July 2002,thirty patients of acetabular fractures were treated with simple bone traction and twenty one patients were treated with open reduction and internal fixation.The traction was applied for 3～4 weeks.The exercises of joints were encouraged and weight bearing was permitted after three months in all patients. Results: Forty four patients were followed up for 1 5～10 years.Twenty five patients of them were in the traction group and nineteen patients were in the operation group.Based on AAOS evaluation,eleven patients were excellent,eight were good,two were fair and four were poor in the traction group.However,in the operation group ten patients were excellent,six were good,one was fair and two were poor. Conclusion: According to the Letournel classification,open reduction and internal fixation is indicated for treatment of anterior and (or) posterior wall with bigger fragment (>40%),the weight bearing area is involved with wider gap and (or) displacement(>3 mm).
出处
《中国骨伤》
CAS
2005年第2期69-71,共3页
China Journal of Orthopaedics and Traumatology
