螺旋CT三维重建对不同入路髋臼骨折手术后功能恢复的评价

目的用螺旋CT三维重建对髋臼骨折手术后功能恢复进行评价。方法对33例髋臼骨折患者的螺旋CT三维重建资料进行分析。发现8例髋臼后壁骨折(均有髋关节后脱位引起),4例前柱骨折,4例髋臼前壁骨折,5例横行骨折,2例前柱伴后方半横行骨折,4例T型骨折,4例双柱骨折,2例后柱骨折。结果8例行髂腹沟入路,19例采用Kocher-Langenbeck入路,6例采用上述联合切口,术后复位按Judet评分,本组12例为解剖复位,21例复位满意,晚期有3例股骨头缺血性坏死发生。关节功能按Matta评分法:优12例,良15例,可4例,差2例。优良率82%。结论螺旋CT三维重建对复杂的髋臼骨折能明确骨折移位、粉碎程度,能显示整个骨盆的轮廓及立体感,对髋臼骨折手术后功能恢复有一定的临床价值。

Spiral CT three dimension reconstruction to assess recovery of function after operation of different operative approach of acetabular fracture

Aim Use spiral CT three dimension to asse ss recovery of function after operation of acetabular fracture.Methods Clinical files of ac-etabular fracture.We have 8cases of acetabular posterior wall fracture(all have hip joint posterior dislocation),4cases of anterior column fracture,4cases of acetabular anterior wall fracture,5cases of transverse fracture,2cases of an-terior column and posterior half fra cture,4case of"T"type fracture,4case of both column fracture,2cases of tran sverse and posterior wall fracture.Results8cases have had ilium-groin approac h.19cases have had Kocher-Langenbeck approach,6cases have had combined a pproach.According to the Judet as-sessment method,anatomical reduction was obtained in 12cases,satisfi ed reduction in 21cases.There were 3cases of ischemia necrosis of head of fe mur after operation in later stage.Acco rding to the Matta assessment method,12cases were excellent,15cases are good,4cases were approve,2cases were dispatch.Conclusion To complicated acetabular fracture spiral CT three di-mension reconstruction can confirm the displacement and the degree of sm ash of the fracture,and can show the outline and third dimension of the whole pelvis.This has very special clinic al significance for recovering to fa ction after operation of acetabular fracture.