【摘要】 目的探讨改良髂股延长入路在复杂髋臼骨折切开复位内固定中的作用。方法1999年6月～2005年12月,36例髋臼骨折按Letournel-Judute分型,其中前壁+横形9例,T形5例,横形+后壁11例,双柱6例,前壁+前柱+后壁+后柱5例;合并股骨头脱位13例;病程1～3周。均采用改良髂股延长入路行切开复位内固定治疗。结果术后均获7～46个月临床随访,平均23.8个月。X线片骨折复位按Matta复位标准,其中解剖复位24例,良好复位8例,差复位4例。根据改良的d’Aubigne和Postel的髋臼骨折临床评分标准获优22例,良好9例,较差5例。结论改良髂股延长入路在复杂髋臼骨折切开复位时,能同时显露髋臼的前壁、前柱和后壁、后柱,同时采用骨与骨的方式重建外展肌群的起止点,使患肢能够早期活动,有利于髋臼的磨造和髋关节功能的恢复。更多还原

【Abstract】 Objective To evaluate the effect of the modified extended iliofemoral approach on treating complex acetabular fractures. Methods Thirty-six cases of complex acetabular fractures were treated by the open reposition and internal fixation by a modified extended iliofemoral approach. Results Thirty-six cases were followed up for 7-46 months, with an average of 23.8 months. According to the Matta standard, anatomical reposition was performed in 24 cases, perfect reposition in 8 cases, and unsatisfactory reposition in 4 cases. By the modified d’Aubigne-postel score, among the 36 cases, 22 had an excellent result, 9 had a good result, and 5 had a poor result. Conclusion The modified extended iliofemoral approach facilitates the operative exposure of the anterior and posterior walls and both columns of the acetabulum in the surgically-treated acetabular fractures by the open reposition and internal fixation. Because of the reconstruction, the functions of the abductor muscle mass managed by the lagscrew-fixed osteotomies of the iliac crest, and greater trochanter, the patients can achieve a rapid rehabilitation of the joint.更多还原