中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2013年
8期
680-684
,共5页
髋臼%骨折%骨折固定术,内%骨板
髖臼%骨摺%骨摺固定術,內%骨闆
관구%골절%골절고정술,내%골판
Acetabulum%Fractures,bone%Fracture fixation,internal%Bone plates
目的 探讨经改良的双窗髂腹股沟入路治疗髋臼前部骨折的疗效. 方法 回顾性分析2011年3月至2012年3月采用切开复位内固定治疗的15例髋臼前部骨折患者资料,男13例,女2例；年龄18 ～53岁,平均36.8岁；骨折根据Judet&Letournel分型:前柱骨折6例,横形伴后壁骨折3例,双柱骨折6例.6例前柱骨折患者采用单纯经改良的双窗髂腹股沟入路(包括耻骨联合上切口和髂嵴切口)复位和固定,其他9例患者加行Kocher-Langenbeck入路复位并固定.记录本组患者的手术时间、术中出血量及术后并发症发生情况.术后采用Matta复位标准评定骨折复位质量,末次随访时采用改良Merle d'Aubigné-Postel评分系统评定髋关节功能. 结果 15例患者术后获平均15个月(9～19个月)随访.15例患者平均手术时间为(223.2 ±85.8) min,平均术中出血量为(993.3±416.6)mL.术后根据Matta复位标准评定骨折复位质量:15例患者骨折均达到解剖复位.1例患者出现股外侧皮肤感觉减退,术后1个月自行恢复.末次随访时采用改良Merle d'Aubigné-Postel评分系统评定疗效:平均评分为16.9分(14～18分),其中优6例,良8例,可1例.术后无一例患者发生异位骨化、感染、骨折不愈合等并发症. 结论 经改良的双窗髂腹股沟入路能够良好复位并固定髋臼前部骨折,具有创伤小、不显露股动静脉和股神经等优点.
目的 探討經改良的雙窗髂腹股溝入路治療髖臼前部骨摺的療效. 方法 迴顧性分析2011年3月至2012年3月採用切開複位內固定治療的15例髖臼前部骨摺患者資料,男13例,女2例；年齡18 ～53歲,平均36.8歲；骨摺根據Judet&Letournel分型:前柱骨摺6例,橫形伴後壁骨摺3例,雙柱骨摺6例.6例前柱骨摺患者採用單純經改良的雙窗髂腹股溝入路(包括恥骨聯閤上切口和髂嵴切口)複位和固定,其他9例患者加行Kocher-Langenbeck入路複位併固定.記錄本組患者的手術時間、術中齣血量及術後併髮癥髮生情況.術後採用Matta複位標準評定骨摺複位質量,末次隨訪時採用改良Merle d'Aubigné-Postel評分繫統評定髖關節功能. 結果 15例患者術後穫平均15箇月(9～19箇月)隨訪.15例患者平均手術時間為(223.2 ±85.8) min,平均術中齣血量為(993.3±416.6)mL.術後根據Matta複位標準評定骨摺複位質量:15例患者骨摺均達到解剖複位.1例患者齣現股外側皮膚感覺減退,術後1箇月自行恢複.末次隨訪時採用改良Merle d'Aubigné-Postel評分繫統評定療效:平均評分為16.9分(14～18分),其中優6例,良8例,可1例.術後無一例患者髮生異位骨化、感染、骨摺不愈閤等併髮癥. 結論 經改良的雙窗髂腹股溝入路能夠良好複位併固定髖臼前部骨摺,具有創傷小、不顯露股動靜脈和股神經等優點.
목적 탐토경개량적쌍창가복고구입로치료관구전부골절적료효. 방법 회고성분석2011년3월지2012년3월채용절개복위내고정치료적15례관구전부골절환자자료,남13례,녀2례；년령18 ～53세,평균36.8세；골절근거Judet&Letournel분형:전주골절6례,횡형반후벽골절3례,쌍주골절6례.6례전주골절환자채용단순경개량적쌍창가복고구입로(포괄치골연합상절구화가척절구)복위화고정,기타9례환자가행Kocher-Langenbeck입로복위병고정.기록본조환자적수술시간、술중출혈량급술후병발증발생정황.술후채용Matta복위표준평정골절복위질량,말차수방시채용개량Merle d'Aubigné-Postel평분계통평정관관절공능. 결과 15례환자술후획평균15개월(9～19개월)수방.15례환자평균수술시간위(223.2 ±85.8) min,평균술중출혈량위(993.3±416.6)mL.술후근거Matta복위표준평정골절복위질량:15례환자골절균체도해부복위.1례환자출현고외측피부감각감퇴,술후1개월자행회복.말차수방시채용개량Merle d'Aubigné-Postel평분계통평정료효:평균평분위16.9분(14～18분),기중우6례,량8례,가1례.술후무일례환자발생이위골화、감염、골절불유합등병발증. 결론 경개량적쌍창가복고구입로능구량호복위병고정관구전부골절,구유창상소、불현로고동정맥화고신경등우점.
Objective To assess the modified two-window ilioinguinal approaches used for the open reduction and internal fixation of anterior wall/column fractures of acetabulum.Methods From March 2011 to March 2012,we treated 15 patients with anterior acetabular fractures by open reduction and internal fixation.They were 13 males and 2 females,18 to 53 years of age (mean,36.8 years).According to Judet & Letournel classification,we had 6 anterior column fractures,3 transverse plus posterior wall fractures 6 double column fractures.The anterior wall/column fractures were reduced and fixated using plates and screws through 2 separate small incisions located on the symphysis pubis and the posterior part of iliac crest,respectively.The posterior components of the acetabular fractures were reduced and fixated by the Kocher-Langenbeck(K-L) approach.Only the modified two-window approaches were used for 6 anterior column fractures,and the other 9 cases used the K-L approach in addition to the modified two-window approaches.The operation time,intra-operative blood loss and postoperative complications were recorded.The quality of fracture reduction was judged according to the Matta scheme and the clinical outcome was measured using the Merle d' Aubigné-Postel rating system.Results All the 15 patients were followed for an average of 15 months (from 9 to 19 months).The mean operation time for the 15 patients was 223.3 ±85.8 minutes and the intra-operative blood loss averaged 993.3 ± 416.6 mL.Anatomical reduction was achieved in all the patients according to the Matta scheme.Lateral femoral cutaneous nerve palsy was observed in one patient but recovered spontaneously one month after operation.The mean Merle d'Aubigné-Postel score at the last follow-up was 16.9 points (from 14 to 18 points).The outcome was defined as excellent in 6 patients,good in 8 and fair in one.No more complication was observed during the follow-up period.Conclusions The modified two-window ilioinguinal approaches can be used for satisfactory reduction and fixation of the anterior wall/column or the anterior components of acetabular fractures.In addition,the modified approaches do not invade very much the soft tissues or need to expose the femoral vessels and nerves.
