螺旋CT三维重建指导髋臼骨折手术入路的选择

目的：用螺旋CT三维重建来指导髋臼骨折手术入路的选择。方法：对33例髋臼骨折患者的螺旋CT三维重建资料进行分析。发现8例髋臼后壁骨折（均有髋关节后脱位引起）,4例前柱骨折,4例髋臼前壁骨折,5例横行骨折,2例前柱伴后方半横行骨折,4例T型骨折,4例双柱骨折,2例后柱骨折。结果：本组8例行髂腹沟入路,19例采用Kocher-Langenbeck入路,6例采用上述联合切口,术后复位按Judet评分,本组12例为解剖复位,21例复位满意,晚期有3例股骨头缺血性坏死发生。关节功能按Matta评分法：优 12例,良 15例,可 4例,差 2例。优良率81.8%。结论：螺旋CT三维重建对复杂的髋臼骨折能明确骨折移位、粉碎程度,能显示整个骨盆的轮廓及立体感,对术前指导骨折的手术入路有一定的临床价值。

Spiral CT three dimension reconstruction to direct the selection operative approach of acetabular fracture

Objective:Use spiral CT three dimension to direct the selection of operative approach of acetabular fracture.(Methods:Clinical) files of acetabular fracture.We have 8 cases of acetabular posterior wall fracture(all have hip joint posterior dislocation),4 cases of anterior column fracture,4 cases of acetabular anterior wall fracture,5 cases of transverse fracture,2 cases of anterior column and posterior half fracture,4 case of "T" type fracture,4 case of both column fracture,2 cases of posterior column fracture.Results: 8 cases have had ilium-groin approach.19cases have had Kocher-Langenbeck approch,6 cases have had combined approach.According to the Judet assessment method,anatomical reduction was obtained in 12 cases,satisfied redution in 21 cases.There are 3 cases of ischemia nerosis of head of femur after operation in later stage.According to the Matta assessment method,12 cases are excellent,15 cases are good,4 cases are approve,2 cases are dispatch.Conclusion:To complicated acetabular fracture spinal CT three dimension reconstruction can confirm the displacement and the degree of smash of the fracture,and can show the outline and third dimension of the whole pelvis.This have very special clinical significance for the selection of approach of operation.hip fractures;Tomography,spiral computed;surgical procedures,elective