摘要
目的:探讨陈旧性髋臼骨折手术治疗的方法及疗效评价。方法:2001年10月至2007年10月手术治疗陈旧性髋臼骨折26例,其中男21例,女5例;年龄18～65岁,平均35.6岁。按Letourne-Judet分型,后壁9例,横形3例,横形加后壁7例,后柱加后壁2例,T形2例,双柱3例。术前经骨盆CT三维重建明确诊断分型后,均采用手术治疗;伤后23～141d手术,平均36.4d。分别采用前、后入路,前后联合入路显露并复位,AO重建钢板内固定。结果:26例获得随访,时间6个月～8年,平均32.4个月。26例患者Matta评分:疼痛(5.04±1.04)分,活动度(5.23±0.76)分,行走情况(4.92±1.16)分,总分(5.06±0.99)分;其中,优6例,良10例,中6例,差4例。术后出现的外侧皮神经损伤3例,坐骨神经损伤2例,股骨头坏死1例,感染1例,异位骨化6例。结论:对陈旧性髋臼骨折的治疗要准确地进行术后评估,严格掌握手术指征,选择恰当的手术入路,正确的复位固定方法,可以获得相对满意的治疗效果。
Objective ：To explore the operative methods and effects of treatment of old aeetabular fractures. Methods： From October 2001 to October 2007,26 patients with old acetabular fractures were treated with operation including 21 males and 5 females with an average age of 34 years ranging from 18 to 65 years. On the basis of the three-dimensional computed to- mography, all cases were diagnosed and classified according to Letourne-Judet classification, 9 cases were posterior wall fracture, 3 cases were lateropulsition fracture, 7 cases were lateropulsition and posterior wall fracture, 2 cases were posterior column and posterior wall fracture, 2 were T-shape fracture, 3 were dual column fracture. These patients were treated through the anterior,posterior, combined anterior-posterior approaches. The time from injured to operation was 33 to 141 days （averaged 36.4 days）. All the fractures were fixed with screws and AO reconstruction plates. Results：All patients were followed up for 6 to 96 months,with an average time of 32.4 months. Evaluated according to Matta criteria,the results of scores was （5.04±1.04） on pain, （5.23 ±0.76）on range of motion, （4.92±1.16）on walking, and tatal （5.06±0.99）on average;The functional results of hip joints were excellent in 6 cases,good in 10 cases,fair in 6 cases,and poor in 4 cases. Sciatic nerve injury was found in 2 patients,lateral femoral cutaneus nerve injury in 3 patients, necrosis of femoral head in 1 patient,infection in 1 patient, and ec- topic bone formation in 6 patients. Conclusion ： Good clinical results can be obtained by careful selection of operative indica- tions of old acetabular fractures in combination with proper operative approach and correct reduction and fixation.
出处
《中国骨伤》
CAS
2010年第5期386-388,共3页
China Journal of Orthopaedics and Traumatology
关键词
髋臼
骨折
外科手术
Acetabulum
Fractures
Surgical procedures,operative
