不同种类植入物置入内固定治疗髋臼横行骨折的理论及其应用

目的:通过检索PubMed、中国科技期刊数据库等就髋臼横行骨折不同内固定材料研究的现状和进展做一综述.资料来源:由调查员进行检索.中文资料检索时间为1990/2009,英文资料检索时间为1980/2009.检索数据库包括PubMed数据库及中国科技期刊数据库.英文检索词为"acetabular/acetabulum,fracture,plate/plates,screw/screws,cable".中文检索词为"髋臼,骨折,内固定,钢板,螺钉,钢丝/张力带".资料选择:纳入标准为髋臼横行骨折手术时机、内固定方法的基础研究、临床研究、综述和病例报道.排除重复及内容、数据不完整的文章.结局评价指标:纳入35篇文献,其中综述3篇,基础研究8篇,临床研究24篇.结果:目前切开复位内固定是髋臼横行骨折的标准治疗方法,其治疗的目标在于髋臼的解剖复位和坚强内固定,从而使早期活动成为可能.重建钢板具有强度大、韧性好、固定牢固、组织相容性好的特点,是目前公认的标准内固定材料.但是,近几年国内外不少学者采用锁定钢板、可吸收螺钉、记忆合金骑缝钉、髋臼记忆内固定系统等内固定取得较好的临床效果.结论:髋臼横行骨折的内固定材料类型较多,目前公认的内固定材料是重建钢板,在实际的手术操作当中,可以灵活的结合使用螺钉,达到更加有效的固定.

Theoretical study and application of different Internal fixations in surgical treatment of transverse acetabular fractures

OBJECTIVE: To summarize the current situation and progress of treating transverse acetabular fractures using different types of internal fixations. DATA SOURCES: The databases including PubMed were retrieved using key words of "acetabular/acetabulum, fracture, plate/plates, screw/screws, cable" both in English and Chinese. DATA SELECTION: The basic research, clinical research, review articles, as well as case reports concerning operation opportunity, and internal fixation methods were included. And repeated papers or articles with incomplete data were excluded. MAIN OUTCOME MEASURES: Totally 35 papers were selected, including 3 review articles, 8 basic research and 24 clinical research. RESULTS: Open reduction and internal fixation has been a preferred treatment for transverse acetabular fractures. The goals of treatment are anatomical reconstruction of articular surfaces and rigid internal fixation of the fragments of the fracture, so that to get early active motion. Reconstruction plate was characterized by great strength, good toughness, stable fixation, as well as excellent histocompatibility, which has accepted as standard internal fixation materials. However, the application of newly developed system, such as locking plate, absorbable screws, shape memory alloy staple, and acetabular memory internal fixation system, has received a better clinical results. CONCLUSIONS: There are plenty of internal fixations can be used in treating transverse acetabular fractures, and the reconstruction plate is the most accepted one. Actually, the internal fixations should be combined together to obtain a good result if necessary.