三种手术入路治疗髋臼骨折的临床疗效探讨

目的探讨三种手术入路治疗髋臼骨折的手术疗效。【方法】采用Kocher—Langenbeck入路23例,髂腹股沟入路19例,前后联合入路4例。[结果]46例患者均得到随访,时间4～48个月。骨折愈合时间4～8个月,内固定物无松动,断裂。参照Matta的髋臼骨折复位标准,解剖复住37例,满意复位6例,不满意复位3例。关节功能按D’Aubigne和Poste16分法评分标准：优27例,良16例,可3例,优良率93．5％。4例出现创伤性关节炎,2例出现异位骨化。1例合并坐骨神经损伤者,术后6个月恢复。【结论】术前准确分析骨折类型,选择正确的手术入路,对骨折进行解剖复位,并采用有效内固定是提高手术疗效的关键。

Study on the Effect of 3 Surgical Approaches for the Treatment of Acetabular Fractures

[Objective] To explore the effect of 3 surgical approaches of acetabular fracture. [Methods] Kocher-Langenbeck approach was used in 23 cases. Ilioinguinal approach was applied in 19 cases. Anterior and posterior combination approach was applied in 4 cases. [Results]All 46 cases were followed up for 4～48 months. The time of fracture healing was 4～8 months. No cinch and break was found in internal fixations. According to the grade of joint function by I3Aubigne and Postel 6 division method, 27 cases were excellent, 16 fine and 3 satisfied. The excellent rate was 93.5%. Traumatic arthritis was found in 4 eases and ectopic ossification was found in 2 cases. One case complicated with ischiadie nerve injury recovered at 6 months after operation. [Conclusion] Analyzing the types of fractures accurately, selecting the correct operation approach, completing the anatomic reduction of the fracture and adopting effective internal fixation are the key to improve the surgical efficacy.