【摘要】 目的对移位复杂髋臼骨折采用不同手术入路与方法,探讨提高其疗效的方法。方法手术治疗有移位髋臼骨折86例,对其中27例有移位复杂髋臼骨折进行了随访。所有骨折均按Letournel-Judet的方法进行分型。根据骨折类型及移位情况,分别采用Kocher-Langenback入路13例,髂腹股沟入路2例,前后联合入路12例,分别进行复位应用骨盆重建钢板和螺钉固定。结果平均随访18.3个月(5～38个月)。根据改良的MerledAubigne和Poste评分标准进行评分,优10例,良12例,一般3例,差2例,优良率81.4%。术后发生骨性关节炎2例,异位骨化7例,经保守治疗痊愈,无死亡、感染及不愈合的病例。结论手术前分析骨折的类型及骨折的移位方向,选择恰当的手术入路及手术中良好的复位是提高髋臼骨折疗效的关键。更多还原

【Abstract】 Objective To analyze operative approaches and their results so as to improve the operative effects of the treatment of displaced complex acetabular fractures. Methods We reviewed 86 cases of displaced acetabular fractures who had been treated operatively. 27 cases with displaced complex acetabular fractures were followed up. All the fractures were classified according to the Letournel-Judet classification. Different approaches were adopted depending on different fractures. Kocher-Langenback approach was adopted in 13 cases, ilioinguinal approach in 2 cases, and double approaches (K-L+ilioinguinal) in 12 cases. Fracture reduction and fixation were carried out with pelvic reconstructive plates and screws. Results The postoperative follow-ups ranged from 5 to 38 months with an average of 18.3 months. Based on the modified Merle d’Aubigne and Poste evaluation system, excellent results were found in 11 cases, good in 12, fair in 3, and poor in 2. The excellent and good rate was 81.4%.Osteoarthritis occurred in 2 cases, and heterotopic ossification in 7 cases,but all healed after non-operative treatment No death or infection or nonunion were found in this series. Conclusions Accurate analysis of fractures preoperatively, reasonable surgical approaches and the quality of surgical reduction are essential to good treatment outcome of acetabular fractures.更多还原