联合入路治疗髋臼骨折

目的探讨联合入路在治疗复杂髋臼骨折中的应用。方法从1998年1月～2001年8月对31例复杂的髋臼骨折行联合入路治疗。男22例,女9例,平均年龄32.3岁,均为高能量损伤。其中交通伤26例,坠落伤5例,合并有其它骨折或内脏损伤14例,平均损伤到手术时间17.6d,平均手术时间252min,术中失血1986ml。按Letournel分类,横行骨折4例,横行 后壁6例,双柱9例,T型8例,前柱 后半横骨折2例,后柱 前半横骨折2例,伴有股骨头移位17例。全部用重建钢板或/和拉力螺钉固定。结果平均随访20.2个月,按Matta标准,解剖复位20例,满意10例,不满意1例;临床结果优良21例,一般8例,差2例。结论联合入路有显露好、复位方便、固定牢靠和异位骨化率低的优点,适用于波及两个柱、复杂的髋臼骨折的治疗。

Treatment of acetabular fractures through the combination approach

Objective To investigate the combination appr oach used to treat the complex acetab ular fractures.Methods Form January 1998to August 2001,31c ases of acetabular fractures were tr eated through combination of Kocher-Langenbeck a nd ilioinguinal approaches.26case s of them resulted from traffic injur ies,and 5from fall injuries.The average interval from injure to operation wa s 17.6days.The average blood loss wa s1890ml.The average operative duration was 252minutes.According to the classification of Letournel and Jud et,associated fracture types accounte d for 27cases,and simple type 4cases.They were fixed by the reconstructi ve plates and /or plates lag screws.Results The average follow-up was 20.2month s.According to criteria of Matta,of the 20cases who underwent a natomic reduction,10were satisfac tory while 1unsatisfactory.21case s had excellent and good clinic results,8fair,2poor.Conclusion Because of the advantages of excelle nt ex-posure,convenient reduction,rigid fixation and lower heterotopic ossification,the combination approach is good to treat the complex acetabular fractu res involved the two columns.