摘要
目的探讨微型钢板结合重建钢板内固定治疗复杂髋臼后壁骨折效果。方法选取2017年2月~2019年1月我院收治的50例根据Judet-Letournel分型为Ⅲ型髋臼后壁骨折患者,随机分为观察组和对照组,每组25例,观察组患者经Kocher-Langenbeck入路显露并复位,联合使用微型钢板及骨盆重建钢板内固定,术后每3个月复查X线片,对照组换采用重建钢板内固定治疗,以Matta的X线复位标准、Matta改良的关节功能D'Aubigne和Postel六分法的标准评价,比较分析两组患者D'Aubignee和Postel评分和术后复位情况。结果根据对本次研究的25例患者进行一年随访发现,依据改良的D'Aubigne和Postel对髓臼骨折的评分情况得出:18分治效果为优,15~17分为良,13~14分为一般,<13分则为差。本组优18例,良5例,一般2例,差0例,优良率为92.00%。观察组患者术后复位满意率显著高于对照组,两组相比差异有统计学意义(P<0.05)。结论选择微型钢板结合重建钢板内固定治疗复杂髋臼后壁骨折对提高手术治疗效果、减少并发症、减少残疾有重要作用。
Objective To explore curative effects of mini-plate combined with reconstruction plate internal fixation in treatment of complex acetabular posterior wall fractures.Methods 50 patients with type III acetabular posterior wall fractures according to Judet-Letournel classification who were admitted and treated in our hospital from February 2017 to January 2019 were selected and they were randomly divided into the observation group and the control group,with 25 cases in each group.Patients in the observation group were exposed and reset by the Kocher-Langenbeck approach,and mini-plate and pelvic reconstruction plate were combinedly used.They were given X-ray reexaminations every 3 months after surgery.The control group was treated with reconstruction plate internal fixation.Matta's X-ray reduction standard and Matta's improved joint function D'Aubigne and Postel sextant standard were used to evaluated.D'Aubigne score,Postel score and postoperative reduction were compared between the two groups.Results According to a one-year follow-up of 50 patients in this study,based on the improved D'Aubigne and Postel scores on medullary fractures,the curative effects of 18 points were excellent,15-17 was good,13-14 was general and less than 13 was poor.In this group,there were 18 excellent cases,5 good cases,2 general cases and 0 poor cases.The excellent and good rate was 92.00%.The postoperative reduction satisfaction rate of the observation group was significantly higher than that of the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion Mini-plate combined with reconstruction plate internal fixation in treatment of complex acetabular posterior wall fractures plays an important role in improving surgical effects,reducing complications and reducing disability.
作者
钟锦祥
张毅锋
肖建春
ZHONG Jinxiang;ZHANG Yifeng;XIAO Jianchun(Department of Orthopedics,Heyuan People's Hospital,Guangdong,Heyuan 517000,China)
出处
《中国医药科学》
2019年第24期271-274,共4页
China Medicine And Pharmacy
基金
广东省河源市科技计划项目(2016-29)
关键词
微型钢板
重建钢板内固定
复杂髋臼后壁骨折
Mini-plate
Reconstruction plate internal fixation
Complex acetabular posterior wall fracturs
