CAJ | 학술논문

目的探讨手术治疗陈旧粉碎性髋臼骨折的适应证、手术技术及疗效. 方法回顾性总结2003年10月-2010年6月因合并其他脏器损伤而延期治疗的陈旧髋臼骨折24例(24髋),男18例,女6例；年龄22～ 68岁[(42.2±10.5)岁].受伤至手术时间3～6周[(4.6±1.3)周].按Letournel分型:简单骨折11例,其中后壁6例,前壁1例,后柱1例,前柱1例,横行2例；复合骨折13例,其中后柱伴后壁6例,横行伴后壁2例,“T”形骨折1例,伴后方半横行骨折2例,双柱2例.手术入路选择髂腹股沟入路2例,髋臼后侧入路13例,联合入路9例. 结果 24例均获得随访,时间10～36个月[(15.6±10.5)个月].依据Matta复位标准:解剖复位21例,不满意2例,差1例.依据改良d' Aubigne-Postel临床结果评分:优21例,良2例,差1例.术后发生股骨头坏死1例,异位骨化11例,坐骨神经一过性麻痹6例. 结论延迟切开复位内固定手术治疗陈旧粉碎性髋臼骨折可取得满意疗效.
목적 탐토수술치료진구분쇄성관구골절적괄응증、수술기술급료효. 방법 회고성총결2003년10월-2010년6월인합병기타장기손상이연기치료적진구관구골절24례(24관),남18례,녀6례；년령22～ 68세[(42.2±10.5)세].수상지수술시간3～6주[(4.6±1.3)주].안Letournel분형:간단골절11례,기중후벽6례,전벽1례,후주1례,전주1례,횡행2례；복합골절13례,기중후주반후벽6례,횡행반후벽2례,“T”형골절1례,반후방반횡행골절2례,쌍주2례.수술입로선택가복고구입로2례,관구후측입로13례,연합입로9례. 결과 24례균획득수방,시간10～36개월[(15.6±10.5)개월].의거Matta복위표준:해부복위21례,불만의2례,차1례.의거개량d' Aubigne-Postel림상결과평분:우21례,량2례,차1례.술후발생고골두배사1례,이위골화11례,좌골신경일과성마비6례. 결론 연지절개복위내고정수술치료진구분쇄성관구골절가취득만의료효.
Objective To investigate the indications,techniques and effects in surgical treatment of stale acetabular comminuted fractures.Methods A retrospective review was made on 24 cases (24 hips) of obsolete acetabular fractures undergone delayed reconstruction due to the combined injuries in other organs from October 2003 to June 2010.There were 18 males and 6 females,at 22-68 years of age [mean (42.2 ± 10.5) years].Mean time from injury to operation was (4.6 ± 1.3) weeks (range,3-6 weeks).According to Letournel classification,there were 11 simple fractures including six posterior wall fractures,one anterior wall fracture,one posterior column fracture,one anterior wall fracture and two transverse fractures and 13 compound fractures including six posterior column with posterior wall fractures,two transverse with posterior wall fractures,one T-shape fracture,two posterior semitransverse fractures and two both-column fractures.Surgery was performed via ilioinguinal approach in two cases,posterior acetabular approach in 13 and the combined approaches in nine.Results All 24 cases were available to average (15.6 ± 10.5) months of follow-up (range,10-36 months).Quality of reduction based on Matta standard was anatomic in 21 cases,unsatisfactory in two and poor in one.Clinical results evaluated using modified d' Aubigne-Postel score were excellent in 21 cases,good in two and poor in one.There were one femoral head necrosis,11 heterotopic ossification and six sciatic nerve transient palsy after operation.Conclusion Delayed open reduction and internal fixation is effective in treatment of obsolete acetabular comminuted fractures.