重建钛板及记忆合金内固定系统治疗髋臼骨折的疗效分析

目的探讨髋臼骨折内固定物的选择及手术策略。方法分别采用髋臼重建钛板螺钉系统及记忆合金三维内固定系统治疗髋臼骨折22例,其中重建钛板螺钉系统固定13例,记忆合金三维内固定系统9例。结果术后随访6~36个月,按Merle d Aubigue临床评定标准,重建钢板螺钉组:优7例,良2例,一般3例,差1例。记忆合金组:优6例,良1例,一般2例。两组间优良率的差异无统计学意义(Fisher精确概率法,P=0.523)。1例5岁儿童因横行髋臼骨折行钛板螺钉系统固定,术后骨折移位,畸形愈合,临床评定差。结论记忆合金三维内固定系统操作简便,固定确实可靠,但不适于严重粉碎骨折;儿童髋臼骨折应解剖复位,牢固固定,必要时可跨骨骺固定,以恢复髋臼的正常结构和发育。

Comparative study of reconstructive plate and acetabular tridimensional memory alloy fixation system in treatment for acetabular fractures

Objective To explore surgical treatment of displaced acetabular fractures. Methods strategy and the choice of internal fixation in the 22 cases of acetabular fracture were treated with open reduction and internal fixation, of which 13 cases were with reconstructive plate and 9 cases were with ATMFS. 22 patients were followed up for 6 to 36 months. The function of the hip was evaluated by Merle d＇Aubigne and Postel score system. Results The results with reconstructive plate were excellent in one case, good in two cases, fair in three cases and poor in one case. The excellent and good rate was 69. 2%. In the cases with ATMFS, excellent results were got in six cases, good in one case, fair in two case, and the excellent and good rate was 77. 8%. There wasn＇t significant difference between reconstructive plate group and ATMFS group by Fisher＇s exact test （ P =0.523 ）. A five years old child suffered transverse acetabular fracture was treated with reconstructive plate and screws. After operation displaced fracture and malformation were observed. The clinical score was poor. Conclusions ATMFS prorides an easy and effective method for the anatomic reconstruction of aeetabular fracture. The unstable pediatric acetabular fractures should be treated by open reduction and fixation in order to restore the structure and development of hip.