腹股沟入路治疗髋臼横型骨折17例体会

目的探讨髋臼横行骨折的手术治疗方法。方法选择2005年1月至2010年12月在宜都市第一人民医院行髂腹股沟入路手术治疗的17例髋臼横行骨折患者,均先行前路手术复位固定,术中C臂机透视,了解复位情况。复位好则结束手术,复位不满意则进行后路复位固定。结果该组患者均获得随访,随访时间为9个月至4.5年,平均21个月。骨折复位质量按Matta标准评定标准,优良率为88.2%,按美国矫形外科学会髋关节功能评价标准,优良率为76.5%,早期出现坐骨神经损伤1例,未出现感染、下肢深静脉栓塞、异位骨化,出现骨性关节炎3例。结论选择其手术入路是治疗的重要环节,决定手术入路的关键因素是骨折类型及其移位方向,决定功能恢复的是解剖复位的程度及手术的时间、合并伤及术后相关的并发症。

Experience of Treatment of 17 Cases of Acetabular Fracture through Ilioinguinal Approach

Objective To investigate the the surgical treatment for acetabular transverse fractures.Methods 17 cases of acetabular transverse fractures from Yidu First People;s Hospital during Jan.2005 to Dec.2010 treated by ilioinguinal surgical approach were selected,all of whom were first given anterior fixation,in-operation C-arm fluoroscopy to understand the fracture situation.In case of the satisfactory reset,the operation was finished,in case of unsatisfactory reset,posterior fixation was done.Results Follow-up for 9 months to 4.5 years(mean 21 months)were done.Quality of fracture reduction by Matta standards assessment:excellent rate 88.2%,American Orthopaedic Society hip function evaluation criteria:excellent rate 76.5%;the early emergence of sciatic nerve injury in 1 case;no infection,deep vein thrombosis,heterotopic ossification;osteoarthritis in 3 patients.Conclusion Choosing surgical approach is an important part of treatment,a key factor determining the surgical approach is the fracture types and the shift direction,the functional recovery is determined by the anatomic degree and surgical time,assoicated injuries and postoperative complications.