髋臼骨折并移位的手术治疗

目的 提高对复杂髋臼骨折的治疗水平。方法 总结１９９３年３月～１９９８年５月对５６例有移位髋臼骨折进行手术治疗的经验。按Ｌｅｔｏｕｒｎｅｌ－ｊｕｄｅｔ骨折分型,髋臼后壁骨折７例,后柱骨折６例,前柱骨折４例,横断骨折６例,Ｔ型骨折６例,后柱伴后壁骨折６例,前方伴后方半横形骨折２例,双柱骨折９例。根据不同骨折类型,分别采用Ｋｏｃｈｅｒ－Ｌａｎｇｅｎｂａｃｋ入路、髂腹股沟和、髂骨股骨入路、扩展的髂骨股骨

Operative treatment of acetabular fractures

OBJECTIVE: To improve the level of the management of complicated acetabular fracture. METHODS: 56 acetabular fractures were treated operatively from March 1993 to May 1998. According to Letournel-Judet classification, 7 cases were posterior wall fracture, 6 posterior column fracture, 4 anterior column fracture, 6 transverse fracture, 6 T-shaped fracture, 10 posterior column combined posterior wall fracture, 6 transverse combined posterior wall fracture, 2 anterior combined posterior hemi-transverse fracture and 6 both column fracture. Kocher-Langebeck approach, illioinguinal approach, illiofemoral approach, extended illiofemoral approach and anterior combined posterior approach were adopted for different fractures with reconstruction plates and screws. RESULTS: 49 of 56 cases were followed up on an average of 26.4 months. According to Matta's evaluation, 19 cases (39%) showed excellent results, 24 (49%) good, 4 (8%) fair, and 2 (4%) poor. Avascular necrosis of the femoral head was found in 4 cases (8%) and heterotopic ossification in 15 cases (30.6%). No death and infection were found in this series. CONCLUSIONS: According to our experience, accurate analysis of fractures preoperatively, reasonable surgical approaches and timing of surgery are essential to good treatment of acetabular fractures.