手术治疗移位髋臼骨折31例

目的探讨移位髋臼骨折的手术方法和疗效。方法回顾分析2003年5月至2009年7月在我院治疗的31例移位髋臼骨折,按Letournel分类方法而采用不同手术入路使用重建钢板及螺钉内固定治疗后壁骨折6例,后柱骨折4例,前壁骨折2例,前柱骨折3例,横行骨折6例,横行伴后壁骨折3例,双柱骨折2例,后壁伴后柱骨折3例,T型骨折2例。结果所有病例获3-36个月随访,按美国矫形外科评价髋关节功能的方法进行评价,优20例,良6例,可3例,差2例,优良率为83.8%。结论术前结合X线CT正确判断髋臼骨折类型,选择合适的手术入路,使骨折复位精确,结合重建钢板和螺钉固定,可获得良好的治疗效果。

Surgical Treatment of the Displaced Acetebular Fracture

Objective To investigate the displaced acetebular fracture and efficacy of surgical methods.Methods We retrospective analysis of May 2003～2009 year in July in our hospital treated 31 cases of displaced acetebular fractrues,Letournel classification methods by using different surgical approach for use of reconstruction plate and screw fixation 6 cases of posterior wall fracture,4 cases of posterior column fracture,2 cases of anterior wall fracture,3 cases of anterior column fracture,6 cases of transverse fracture,3 cases of transverse with posterior wall fracture,2 cases of double-column fractures,3 cases of posterior column with posterior wall fracture,2 cases of T-type fracture.Results All patients were followed up for 3～36 months,according to the U.S.orthopedic evaluation of hip joint function evaluation methods：The clinical outcome was excellent in 20 patients,good in 6,far in 3 and poor in 2.The overall good to excellent rate was 83.8%.Conclusion Preoperative combination of X ray and CT to determine the correct type of acetabular fractures,select the appropriate surgical approach,so that accurate reduction of fracture,with reconstruction plate and screw fixation,access to good therapeutic effect.