手术治疗严重复杂髋臼骨折78例

目的探讨手术治疗严重复杂髋臼骨折的临床疗效。方法严重复杂髋臼骨折78例按照Letournel分型,复合型骨折78例,其中“T”形骨折16例,横形伴后壁骨折22例,后柱伴后壁骨折9例,前柱伴后半横形骨折2例,双柱骨折29例。手术入路:采用Kocher-Langenbeck(K-L)入路22例,髂腹股沟入路25例,扩展髂股入路7例,联合入路(髂腹股沟加K-L入路)24例。结果按Matta评定法,本组优26例,良35例,尚可15例,失败2例,优良率78.2%。结论正确分析骨折移位和类型、选择适当的手术路径是提高髋臼骨折治疗效果的重要保证,手术疗效与骨折复位质量密切相关。

Surgical Treatment of 78 Patients with Serious Acetabular Fractures

Objective To investigate the clinical effect of surgical treatment of acetabular fractures.Methods According to Letournel typing, complexed fracture 78 cases (16 cases of T shaped fractures, 22 cases of transverse and posterior wall fractures, 9 case of posterior column and wall fractures, 2 cases of anterior and hemi-transverse fractures and 29 cases of fractures of both column). Kocher Langenbeck(K-L) approach was applied in 22 cases, ilioinguinal approach in 25, extended iliofemoral approach in 7, and combined approaches (K-L plus ilioinguinal) in 24.Results According to Matta evaluation,78 cases were treated with open reduction and internal fixation,excellence 26, good 35,acceptable 15, failure 2.The fineness rate was 78.2%.Conclusion It is the important guarantee to elevate the therapeutic efficacy of acetabular fracture that shoud be correctly analysed the fracture displacement and type, chose proper surgical approach, have good restitution implement and operated at the right moment. The quality of surgical reduction has a close correlation with the clinical results.