CAJ | 학술논문

目的：探讨应用Kocher-Langenbeck入路加大转子截骨手术治疗髋关节后脱位并髋臼后柱(壁)骨折的手术方法和疗效。方法收集14例采用Kocher-Langenbeck入路结合大转子截骨手术治疗的髋关节后脱位并髋臼后柱(壁)骨折病例,分析其手术方法、术中情况及术后恢复情况。结果平均手术时间为105 min,术中平均出血量为600 mL。术后解剖复位5例,良好复位8例,复位不满意1例。临床效果优7例,良4例,可3例。3例出现异位骨化,4例发生创伤性关节炎。髋臼后柱(壁)、大转子截骨断端均骨性愈合,无医源性坐骨神经损伤及股骨头缺血坏死。结论应用Kocher-Langenbeck入路加大转子截骨治疗髋关节后脱位并髋臼后柱(壁)骨折,术中显露情况良好,有利于骨折、脱位的复位及固定。
목적：탐토응용Kocher-Langenbeck입로가대전자절골수술치료관관절후탈위병관구후주(벽)골절적수술방법화료효。방법수집14례채용Kocher-Langenbeck입로결합대전자절골수술치료적관관절후탈위병관구후주(벽)골절병례,분석기수술방법、술중정황급술후회복정황。결과평균수술시간위105 min,술중평균출혈량위600 mL。술후해부복위5례,량호복위8례,복위불만의1례。림상효과우7례,량4례,가3례。3례출현이위골화,4례발생창상성관절염。관구후주(벽)、대전자절골단단균골성유합,무의원성좌골신경손상급고골두결혈배사。결론응용Kocher-Langenbeck입로가대전자절골치료관관절후탈위병관구후주(벽)골절,술중현로정황량호,유리우골절、탈위적복위급고정。
Objective To introduce the operation method and curative effect of posterior dislocation and acetabular posterior column ( wall) fracture with greater trochanteric osteotomy via Kocher-Langenbeck approach. Methods 14 cases of posterior dislocation and ace-tabular posterior column( wall) fracture who were treated by greater trochanteric osteotomy via Kocher-Langenbeck approach were collected, and the surgical methods, intraoperative situation and postoperative recovery were analyzed. Results The mean operating time is 105 min and the mean bleeding volum is 600 mL. After operation, there were 5 cases of anatomical reduction;8 cases of good reduction;1 cases of unsatisfactory reduction. Among the patients, 7 cases were of excellent clinical effect;4 cases were of good clinical effect, 3 cases were of medium clinical effect. Heterotopic ossification occurred in 3 cases and traumatic arthritis occurred in 4 case. Both acetabular posterior col-umn ( wall) and trochanter osteotomy ends were healed, and there was no iatrogenic sciatic nerve and femoral head necrosis injury. Conclu-sion In treatment of posterior dislocation and acetabular posterior column ( wall) fracture, greater trochanteric osteotomy via Kocher-Lange-nbeck approach can provide excellent exposure, and it is conducive to the reduction and fixation of fracture and dislocation.