9例髋臼骨折的手术治疗

目的探讨髋臼后壁(或后壁加后柱)骨折的手术治疗方法。方法2001年8月～2005年12月,收治髋臼骨折患者9例,男性8例,女性1例,年龄37～56岁,平均41.7岁;按Letournel-Judet分类法,本组7例属单纯后壁骨折,2例为后壁加后柱骨折,对8例行切开复位钢板内固定术,对1例用2块重建钢板固定后壁和后柱。结果在9例患者中,1例失访,8例获随访,时间12～36个月,平均18个月,骨折均愈合。1例发生股骨头缺血性坏死。1例发生髋关节创伤性关节炎,症状轻微,保守治疗中;1例原发性坐骨神经损伤(后壁骨折加髋关节后脱位),术中探查松解,半年后恢复;1例医源性坐骨神经不完全损伤,3个月后恢复。结论经Kocher-Langenbeck入路,切开复位,用重建钢板内固定,是治疗髋臼后壁(或后壁加后柱)骨折的有效方法。

Surgical treatment for acetabular fracture -9 case report

Objective To investigate the surgical treatment for the fracture of posterior wall of acetabulum.Methods 9 patients with the acetabular fractures were treated.The range of age is 37 to 56years old and the mean age is 41.7years old.According to Letournel-Judet Classification,7 cases were simple fracture of posterior wall of acetabulum and 2 cases were combining fractures of both posterior wall and posterior column of acetabulum.Open reduction and internal fixation with reconstructive plates were performed for these patients.Kocher-Longenbeck approach was used during the operation.Results 8 patients were followed up from 12 to 36 months and mean time is 18 months.The other 1 patient was lost follow up.All fractures were healed uneventfully.6 patients recovered walking function 12 months postoperatively.1 patient had severe pain on his injured hip because of the femoral head necrosis.1 patient had mild pain on his injured hip only after long walking.There was a sign of posttraumatic arthritis in the injuried hip.1 patient had mild iatrogenic injury of the sciatic nerve and recovered fully 3 months postoperatively.Conclusions Open reduction and internal fixation with reconstructive plate through Kocher-Longenbeck approach for the fractures of posterior wall of acetabulum is effective,safe and reliable.