摘要
目的 探讨提高髋臼骨折复位质量的方法。 方法 自 1995年 3月至 2 0 0 1年 8月 ,共手术治疗移位的髋臼骨折 89例。按Letournel法进行分类 ,后壁骨折 2 7例 ,后柱骨折 5例 ,前柱骨折 3例 ,横断骨折 15例 ,双柱骨折 15例 ,后柱 +后壁骨折 13例 ,横断 +后壁骨折 6例 ,“T”形骨折5例。选择Kocher-langenbeck切口 4 6例 ,髂腹股沟切口 2 7例 ,扩大的髂股切口 1例 ,前后联合切口 15例。 结果 根据Matta提出的复位标准及Merled’Aubigne提出的临床评定标准 ,复位优良率为 6 8.5 % (6 1/ 89) ;复位满意组临床评定优良率为 73.8% (45 / 6 1) ,复位不满意组临床评定优良率为 35 .7% (10 / 2 8)。 结论 髋臼骨折的复位质量是决定临床手术疗效的关键。把握手术时机、正确选择切口、注意手术顺序、正确放置钢板和置入螺钉 ,以及提高手术医师的临床经验 ,是提高复位质量的关键。
Objective To discuss the method for improving reduction quality of acetabular fractures. Methods From March 1995 to August 2001, 89 cases with displaced acetabular fractures were managed surgically. According to Letournel classification method, there were 27 posterior wall, 5 posterior column, 3 anterior column, 15 transverse, 15 both column, 13 posterior column / posterior wall, 6 transverse / posterior wall, 5 T shape fractceres. Results The average follow-up period was 15.7 months (12-45 months). According to the reduction grade of Matta and clinical evaluation criteria of Merle d' Aubigne, 61 cases obtained excellent reduction quality with an excellence rate of 68.5% (61/89) . The excellence rate by clinical evaluation criteria was 73.8% (45/61) in the satisfactory reduction group and 35.7% (10/28) in the unsatisfactory reduction group. Conclusions The reduction quality is the key factor to effect of acetabular surgery. It is crucial for a high reduction quality to hold right operation time, choose proper operative approach, select correct incision, pay attention to surgical management order, exactly place the plate and implant the screws as well as improve the surgeon’s clinical experience.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2003年第12期731-733,共3页
Chinese Journal of Trauma
