摘要
目的探讨髋臼骨折手术复位技巧，提高手术复位率。方法总结1995年9月-2005年10月259例手术治疗髋臼骨折的经验，并分析其临床疗效。结果解剖复位（移位≤1mm）203例，占78．4％。简单型髋臼骨折解剖复位率为96．0％（120／125）；复杂型髋臼骨折解剖复位率为61．9％（83／134），其中双人路解剖复位率为77．8％（42／54），单人路为51．3％（41／80）。满意复位（移位2～3mm）42例，占16．2％，其中简单型髋臼骨折5例，复杂型髋臼骨折37例；不满意复位（移位≥3mm）14例，占5．4％，均为复杂型髋臼骨折。187例获远期随访，随访时间8个月～6年6个月，平均2年5个月。按改良的Postel—D’Aubignel临床结果评分标准：优98例（占52．4％），良40例（21．4％），一般34例（18．2％），差15例（8．0％），优良率为73．8％。非解剖复位组优良率为38．9％（14／36）；解剖复位组优良率为82．1％（124／151），差异有统计学意义（x^2=28．1，P〈0．01）。结论提高复位技术、正确处理各个治疗环节，才能在有限的切口内提高位置深在、周围解剖关系复杂的髋臼骨折手术复位率。
Objective To study the technique of operative reduction of displaced acetabular fractures to increase the operative reduction rate. Methods The experiences of 259 patients treated with open reduction and internal fixation were summed up and the clinic effect was analyzed. Results Anatomical reduction （ displace ≤ 1mm ） was applied in 203 （ 78. 4% ） patients, including 120/125 （96.0%） patients with simple acetabular fracture and 83/134 （61.9%） patients with complex acetabular fracture, among them 42/54 （77.8%） patients were managed by two approaches and 41/80 （51.3% ） by one approach. Satisfactory reduction （displace 2-3 ram） was attained in 42 （ 16.2% ） patients, including 5 patients with simple and 37 patients with complex acetabular fractures. Unsatisfactory reduction （displace 〉 3 nun） was in 14 （5.4%） patients of complex acetabular fracture. 187 patients were followed up for 8-78 months （ mean： 29 months）. The hip function was evaluated according to the modified Postel-D＇ Aubigne score and rated as excellent in 98 patients （52.4%） , good in 40 patients （21.4%） , fair in 34 patients （ 18.2% ） and poor in 15 patients （8.0%）. The excellent and good rate was 73.8%. In the anatomic reduction group the excellent and good rate was 82.1% （ 124/151 ） ,and 38.9% （14/36） in the non-anatomic reduction group; a significant difference was noted between the two groups （X2 = 28.1 ,P 〈 0.01 ）. Conclusion To improve reduction techniques, correct management in each step of treatment is the key to increase the operative reduction rate of acetabular fractures.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2007年第3期193-197,共5页
Chinese Journal of Trauma
关键词
髋臼
髋骨折
骨折固定术
内
Acetabulum
Hip fractures
Fracture fixation, internal
