【摘要】 目的探讨根据Judet-Letournel分型选择个体化手术入路手术治疗髋臼骨折的疗效。方法回顾性分析自2010-01—2015-05诊治的14例髋臼骨折。骨折根据Judet-Letournel分型:前柱骨折1例,后壁骨折1例,后柱骨折2例,横断伴后壁骨折2例,T形骨折2例,双柱骨折2例,前方伴后方半横形骨折4例。根据Judet-Letournel分型选择手术入路,所有患者均用重建钢板配合拉力螺钉内固定及选择性植骨治疗。结果骨折复位按照Matta评分标准评定:解剖复位11例,满意复位2例,不满意复位1例,复位满意率92.9%。14例均获随访1.2~5.0(3.2±0.8)年。末次随访疗效按改良Merle D’Aubigne和Postel评分系统评定:优10例,良2例,可2例。随访期内无内固定松动、异位骨化及深静脉血栓形成。结论根据Judet-Letournel分型系统选择个体化手术入路及复位内固定,选择性植骨治疗髋臼骨折具有固定可靠、并发症少等优点,能显著提高疗效。更多还原

【Abstract】 Objective To investigate the effect of the selected surgical approach according to Judet-Letournel classification for treatment of acetabular fractures. Methods From Jan 2010 to May 2015, a retrospective analysis was performed on 14 cases of acetabular fractures treated. According to the Judet-Letournel classification: 1 cases of anterior column fracture, 1cases posterior wall fracture, 2 cases of posterior column fracture, 2 cases of transverse with posterior wall fracture, 2 cases of "T" shape fracture, 2 cases of double column fracture, 4 cases of anterior with posterior half transverse fractures. All patients were treated with reconstruction plate combined with lag screw fixation and selective bone grafting by selected surgical approach according to Judet-Letournel classification. Results According to the Matta score standard, 11 cases of anatomical reduction, 2 cases with satisfactory reduction, 1 case with unsatisfactory reduction. The satisfaction rate of reduction was92.9%. Fourteen cases were followed up for 1.2 to 5 years. The hip function was evaluated by improved D’ Aubigne Merle and Postel scoring system: excellent in 10 cases, good in 2 cases, fair in 2 cases. The excellent and good rate was 85.7%. The internal fixation loosening and heterotopic ossification and deep vein thrombosis were found in none of the patients during follow-up. Conclusion The individual approach selected according to the Judet-Letournel classification system and internal fixation techniques and selective bone graft for treatment of acetabular fracture can significantly improve the curative effect with reliable fixation and low complication.更多还原