单-K—L切口配合前柱钛板螺钉复位技术治疗严重髋臼双柱骨折

目的：探讨严重髋臼双柱骨折手术治疗的复位技巧以及术中如何尽可能减少手术对软组织的再次损伤。方法：2005年1月～2008年3月我院对24例24髋被确诊为髋臼双柱骨折的患者进行开放复位内固定术。全部采用单一的K—L入路并应用钛板螺钉复位技术对前柱进行复位固定，术后进行36个月以上的随访并分别在第3、6、12、18、24、36个月记录Harris评分和拍摄X线片。结果：本组24例24髋平均手术时间为82min，平均出血量480ml，术后所有患髋皆获得了良好头臼匹配，第36个月Harris评分平均为91分。结论：运用单一的K—L入路并应用钛板螺钉复位技术对前柱进行复位固定治疗严重髋臼双柱骨折具有手术时间短、出血少、前柱复位固定容易的优点，远期疗效良好。

Observation of single Kocher-Langenbeck(K-L)approach and anterior column with titanium plate and screw in the treatment of complex acetabular dual-column fracture

Objective： To explore the reduction skill for complex acetabular dual-column fracture, and reduce the injury for the soft tissues. Methods： From January 2005 to March 2008, 24 cases （24 hips） of the patients with acetabular anterior and posterior column fractures were surgically treated with open reduction of anterior column with titanium plate and screw through a single Kocher-Lengenbeck approach in our hospital. All the patients were followed up at least 36 months. The Harris score and X--xay were recorded at 3, 6, 12, 18, 24, 36 months after operation. Results： The mean operating time of 24 cases （24 hips） was 82 minutes with a mean volume of 480 ml intraoperative blood loss. All the hips had a good congruence postoperation. The average Harris hip score was 91 points at 36 months. Conclusion： Internal fixation through a single K- L approach and reduction of anterior column with titanium plate and screw has short operating time and blood loss, easy reduction and fixation for anterior eolum. Good clinical results can be obtained.