【摘要】 目的探讨髋臼骨折复位内固定器治疗髋臼方形区骨折的临床疗效。方法采用髋臼骨折复位内固定器治疗24例髋臼方形区骨折患者。记录手术时间、出血量、术后并发症发生情况。采用Matta标准评估骨折复位质量及影像学结果,采用改良Merle D’Aubigné-Postel评分评估临床疗效。结果患者均获得随访,时间24～60(45.7±13.0)个月。手术时间105～210(110.3±30.8) min,出血量300～1 500(950.6±348.6) ml。切口均一期愈合,术后无股骨头再脱位、神经血管损伤等并发症发生。骨折均愈合,时间3～5(4.3±0.8)个月。术后3 d采用Matta标准评估骨折复位质量:解剖复位17例,复位不良5例,复位差2例。末次随访时,采用改良Merle D’Aubigné-Postel评分评价的临床疗效优良率为21/24;采用Matta标准评估的影像学结果优良率为20/24。结论采用髋臼骨折复位内固定器治疗髋臼方形区骨折,手术操作相对简单、安全且省时,可预防股骨头再脱位、维持解剖复位,为骨折愈合提供条件,尤其适用于髋臼方形区严重粉碎性骨折。更多还原

【Abstract】 Objective To investigate the clinical effect of acetabular fracture reduction internal fixator( AFRIF) in the treatment of acetabular square fracture. Methods Twenty-four patients with acetabular square fractures were treated with AFRIF. The operation time,blood loss volume and complications were recorded. Matta standard was used to evaluate the quality of fracture reduction and imaging results,and modified Merle D’Aubigné-Postel score was used to evaluate the clinical effect. Results All patients were followed up for 24 ～ 60( 45. 7 ± 13. 0) months. The operation time was 105 ～ 210( 110. 3 ± 30. 8) min,and the blood loss was 300 ～ 1 500( 950. 6 ± 348. 6) ml. All the incisions healed in the first stage,and no recurrence and redislocation of femoral head,neurovascular injury and other complications occurred. All fractures healed in 3 ～ 5( 4. 3 ± 0. 8) months. Matta standard was used to evaluate the quality of fracture reduction at 3 dafter the operation: anatomical reduction in 17 cases,poor reduction in 5 cases and bad reduction in 2 cases. At the last follow-up,the excellent and good rate of clinical efficacy evaluated by modified Merle D’Aubigné-Postel score was 21/24,and the excellent and good rate of imaging results evaluated by Matta standard was 20/24. Conclusions The operation of acetabular square fracture with AFRIF is relatively simple,safe and timesaving. It can prevent the redislocation of the femoral head,maintain anatomical reduction,and provide conditions for fracture healing. It is especially suitable for severe comminuted fractures in the acetabular square area.更多还原