【摘要】 目的探讨经K-L入路内固定治疗髋白骨折的临床疗效。方法对35例髋臼骨折患者采用K-L入路内固定治疗。随访观察固定效果。结果患者均获随访,时间1~12(4.2±1.1)年。骨折均获愈合,时间12.5~14.6(14.2±0.5)周。末次随访依据Merle d’Aubigne-Postel髋关节评分标准评价临床疗效:优15例,良11例,可4例,差5例,优良率达74.3%。参照Matta标准评价骨折复位:解剖复位22例,满意复位10例,不满意复位3例。术后1例伤口感染,1例坐骨神经损伤,1例泌尿系统结石,1例异位骨化,4例股骨头缺血性坏死,3例创伤性关节炎。其中合并股骨头(颈)骨折患者易发生术后股骨头缺血性坏死,与术前无股骨头(颈)骨折患者比较差异有统计学意义(P<0.05)。结论经K-L入路内固定手术治疗部分髋臼骨折可取得较良好结果,保护股骨头血供可预防术后并发症进而提高手术疗效。更多还原

【Abstract】 Objective To investigate the clinical effect of acetabular fractures treated with reconstruction plate through the K-L approach. Methods 35 patients with acetabular fractures were treated with reconstruction plate via the K-L approach. All the patients were followed up and the fixation effect was observed. Results All cases were followed up for 1 ~ 12( 4. 2 ± 1. 1) years. Bone union was achieved in all cases,and the time was 12. 5 ~ 14. 6(14. 2 ± 0. 5) weeks. According to Merle d’Aubigne-Postel criteria at the final follow-up,15 cases were excellent,11 good,4 fair and 5 poor,the clinical excellent and good rate was 74. 3%. Based on the Matta standards,the fracture reduction results were as follows: 22 cases were anatomic reduction,10 satisfactory reduction,3 unsatisfactory reduction. Postoperative complications were wound infection(1 case),sciatic nerve injury( 1 case),urinary tract stones(1 case),avascular necrosis(4 cases),and traumatic arthritis(3 cases). Combination with femoral head(neck) fractures had an tendency to postoperative ischemic necrosis and delayed hip dislocation increased the postoperative complications rate( P < 0. 05). Conclusions Part of the acetabular fractures can be treated with internal fixation via K-L approach and achieve relatively good results. Protection of the blood supply of the femoral head may reduce the postoperative complications and improve the clinical effects.更多还原