齐齐哈尔医学院学报
齊齊哈爾醫學院學報
제제합이의학원학보
JOURNAL OF QIQIHAR MEDICAL COLLEGE
2014年
20期
2984-2985,2986
,共3页
蒋勤益%肖黎%丁华%汪雷
蔣勤益%肖黎%丁華%汪雷
장근익%초려%정화%왕뢰
髋关节后脱位%股骨头骨折%治疗方法
髖關節後脫位%股骨頭骨摺%治療方法
관관절후탈위%고골두골절%치료방법
Posterior hip dislocation%Femoral head fracture%Treatment
目的:探讨髋关节后脱位合并股骨头骨折的治疗方法与愈合评价。方法分析16例髋关节后脱位合并股骨头骨折患者的分型、治疗时间及治疗方式。随访时间3~8年(平均4年)。以影像学检查及髋关节功能恢复情况评价其愈后。结果16例髋关节后脱位合并股骨头骨折患者按Pipkin分类法分型,Ⅰ型:髋关节后脱位伴股骨头中央凹尾端的骨折,12例(占75.0%);Ⅱ型:髋关节后脱位伴股骨头中央凹头端的骨折,3例(占18.8%);Ⅲ型:Ⅰ型或Ⅱ型骨折伴股骨颈骨折,0例(占0%),Ⅳ型:Ⅰ型、Ⅱ型或Ⅲ型骨折伴髋臼骨折,1例(占6.3%)。对16例获得随访者按HHS(Harris Hip Score)功能评价标准,Ⅰ型中效果优为9例,良2例,差1例,Ⅱ型中效果优为1例,良1例,差1例,Ⅳ型中效果可1例。结论髋关节后脱位合并股骨头骨折的治疗方法应根据损伤机制、骨折脱位类型确定,其中对于PipkinⅠ型骨折可予以闭合复位后牵引治疗,而对于PipkinⅡ型或Ⅲ型骨折手术治疗是较为理想的选择。
目的:探討髖關節後脫位閤併股骨頭骨摺的治療方法與愈閤評價。方法分析16例髖關節後脫位閤併股骨頭骨摺患者的分型、治療時間及治療方式。隨訪時間3~8年(平均4年)。以影像學檢查及髖關節功能恢複情況評價其愈後。結果16例髖關節後脫位閤併股骨頭骨摺患者按Pipkin分類法分型,Ⅰ型:髖關節後脫位伴股骨頭中央凹尾耑的骨摺,12例(佔75.0%);Ⅱ型:髖關節後脫位伴股骨頭中央凹頭耑的骨摺,3例(佔18.8%);Ⅲ型:Ⅰ型或Ⅱ型骨摺伴股骨頸骨摺,0例(佔0%),Ⅳ型:Ⅰ型、Ⅱ型或Ⅲ型骨摺伴髖臼骨摺,1例(佔6.3%)。對16例穫得隨訪者按HHS(Harris Hip Score)功能評價標準,Ⅰ型中效果優為9例,良2例,差1例,Ⅱ型中效果優為1例,良1例,差1例,Ⅳ型中效果可1例。結論髖關節後脫位閤併股骨頭骨摺的治療方法應根據損傷機製、骨摺脫位類型確定,其中對于PipkinⅠ型骨摺可予以閉閤複位後牽引治療,而對于PipkinⅡ型或Ⅲ型骨摺手術治療是較為理想的選擇。
목적:탐토관관절후탈위합병고골두골절적치료방법여유합평개。방법분석16례관관절후탈위합병고골두골절환자적분형、치료시간급치료방식。수방시간3~8년(평균4년)。이영상학검사급관관절공능회복정황평개기유후。결과16례관관절후탈위합병고골두골절환자안Pipkin분류법분형,Ⅰ형:관관절후탈위반고골두중앙요미단적골절,12례(점75.0%);Ⅱ형:관관절후탈위반고골두중앙요두단적골절,3례(점18.8%);Ⅲ형:Ⅰ형혹Ⅱ형골절반고골경골절,0례(점0%),Ⅳ형:Ⅰ형、Ⅱ형혹Ⅲ형골절반관구골절,1례(점6.3%)。대16례획득수방자안HHS(Harris Hip Score)공능평개표준,Ⅰ형중효과우위9례,량2례,차1례,Ⅱ형중효과우위1례,량1례,차1례,Ⅳ형중효과가1례。결론관관절후탈위합병고골두골절적치료방법응근거손상궤제、골절탈위류형학정,기중대우PipkinⅠ형골절가여이폐합복위후견인치료,이대우PipkinⅡ형혹Ⅲ형골절수술치료시교위이상적선택。
Objective To discuss the treatment method and prognosis of posterior hip dislocation combined with femoral fractures .Methods Twenty-nine patients who had been diagnosed as cases of posterior hip dislocation combined with femoral head fracture were reviewed , with their type of fracture , timing of treatment and method of treatment analyzed .16 cases were followed up from 2003 to 2011 for an average period of 6 years. Their prognosis was evaluated according to the x-ray radiography and the function of hip joints .Results According to Pipkin classification , 12 cases were PipkinⅠ, 3 cases PipkinⅡ, 0 cases PipkinⅢ(10%) , and 1 cases Pipkin Ⅳ.In type I, 9 cases were rated as excellent , 2 good, and 1 poor by Harris hip score .In typeⅡ, 1case was rated as excellent , 1case good , and 1 poor.In type Ⅳ , 1 fair .Conclusions The choice of treatment method should be determined by the mechanism of injury and the type of fracture .