髋臼移位骨折的治疗

目的比较手术与牵引两种方法治疗髋臼移位骨折的疗效.方法根据Judet-1etoumel分型后壁骨折3例,后柱骨折9例,前柱骨折5例,横行骨折3例,横行伴后壁骨折4例,双柱骨折3例,后柱伴后壁骨折5例,"T”型骨折2例.其中简单骨折4例、复杂骨折12例手术治疗,采用KocheR-Langenbeck切口、延长髂股切口及改良Oi1ler切口,用钢板螺钉内固定.保守治疗18例,牵引8周.随访10月～54月,平均26月.结果手术组解剖复位占81.25%,满意复位占12.5%;优良率为87.5%,可差各占6.25%.牵引组无解剖复位,满意复位占278%,不满意复位占72.22%;优良率占55.56%,差占16.67%.结论手术治疗效果优于牵引治疗.

Treatment of Displaced Acetabular Fractures

Objective: To compare the results of the operative treatment and the closed treatment of displaced acetabular fractures. Methods: There were 34 patients in the study including 3 posterior wall, 9 posterior column, 3 anterior column, 1 transverse fracture, 4 transverse fractures associated with posterior wall, 4 both columns, 7 posterior wall associated with posterior column and 3 the T-shaped according to Judet-Letormal classification. 4 cases of the simple fractures and 12 cases of the complicated fractures were operated. The surgical approaches were adopted respectively, Kocher-Langebeck, iliofemoral and reformed Oiller in these cases. Other patients were treated with skeletal traction for 8 weeks. All cases were followed up for 10~54 months with an average of 26 months. Results: Anatomical reduction was achieved in 81.25% and reduction was achieved in 12.5% with operative group. The result was excellent or good in 87.5% of these patients in which the operative group. There was not anatomical reduction in the tractive group. Reduction was achieved in 27.78% with the tractive group and the displaced after reduction was not achieved less than 3mm in 72.22%. The result of the tractive group was excellent or good in 55.56%, fair in 27.78%, poor in 16.67%. Conclusion: Operative outcome of the displaced acetabular fracture might be better than the closed treatment.