【摘要】 目的:研究影响髋臼骨折术后继发创伤性关节炎发生的影响因素,并分析全髋关节置换术或全髋关节表面置换术对并发创伤性关节炎患者预后的影响。方法:回顾性分析2016年8月至2019年8月于我院进行手术治疗的180例髋臼骨折患者临床资料及随访资料,记录所有患者性别、年龄、骨折原因、类型、手术情况等资料及创伤性关节炎发生情况,分析创伤性关节炎治疗及预后,采用多因素Logistic回归分析对继发性创伤性关节炎危险因素进行分析。结果:180例髋臼骨折手术患者术后出现创伤性关节炎发生率为26.67%;术后发生创伤性关节炎患者在复杂型骨折、存在股骨头软管缺损、伤后≥10d进行手术、术后复位质量差及术后劳动强度大的构成比上显著高于未发生创伤性关节炎患者,比较差异间具有统计学意义(P<0.05);复杂型骨折、存在股骨头软管缺损、伤后≥10d进行手术、术后复位质量差及术后劳动强度过大是导致髋臼骨折术后发生创伤性关节炎的独立危险因素(P<0.05)。48例创伤性关节炎患者中30例接受全面髋关节置换术治疗,18例接受全面髋关节表面置换术治疗,所有患者术后髋关节功能均得到明显改善,且无感染、假体松动和关节脱位发生。结论:髋臼骨折术后创伤性关节炎不可小觑,尤其针对复杂型骨折、存在股骨头软管缺损、伤后太长时间进行手术、术后复位质量差及术后劳动强度过大患者,应针对性给予干预措施降低创伤性关节炎发生率,而针对并发创伤性关节炎患者,全面髋关节置换术与全面髋关节表面置换术均具有一定的临床疗效及安全性。更多还原

【Abstract】 Objective: To study the influencing factors of the occurrence of secondary traumatic arthritis after surgery for fracture of acetabulum,and analyze the impact of total hip arthroplasty or total hip surface arthroplasty on the prognosis of patients with traumatic arthritis.Methods : The clinical data and follow-up data of 180 patients with acetabular fracture undergoing surgical treatment in our hospital from August 2016 to August 2019 were retrospectively analyzed. All the patients’ sex,age,fracture cause,type,operation situation and the occurrence of traumatic arthritis were recorded. The treatment and prognosis of traumatic arthritis were analyzed,and the risk factors of secondary traumatic arthritis were analyzed by multivariate logistic regression analysis. Result: The incidence of postoperative traumatic arthritis in 180 patients with acetabular fracture surgery was 26.67%. Compound fracture,femoral head hose defects,surgery ≥10 days after injury,poor quality of postoperative reduction of fracture,and postoperative intense labor in patients with postoperative traumatic arthritis played a much greater role and the differences were statistically significant( P <0.05). Compound fractures,femoral head tube defects,surgery ≥10 days after injury,poor postoperative reduction quality,and excessive postoperative labor intensity are independent risk factors for traumatic arthritis after acetabular fracture( P<0.05).In the 48 patients with traumatic arthritis,30 patients were treated with total hip replacement and18 were treated with total hip surface replacement. All patients had significantly improved in hip joint function after operation,and no infection,loosening of prosthesis and joint dislocation. Conclusion: Traumatic arthritis after acetabular fracture should not be underestimated,especially for patients with compound fractures,femoral head tube defects,delayed surgery after injury,poor quality of postoperative reduction,and excessive postoperative labor intensity,targeted interventions should be given to reduce the incidence of traumatic arthritis.For patients with complicated traumatic arthritis,total hip replacement and total hip surface replacement have clinical efficacy and safety.更多还原