有移位的髋臼骨折的治疗

目的：探讨有移位的髋臼折的最佳治疗方法。方法：总结1993年4月－2000年1月62例有移位的髋臼骨折进行治疗的经验。手术治疗组47例，按Judet等方法对骨折进行分型，46例根据分类结果选用适当的手术入路，行切开复位内固定，1例行全髋置换术。非手术治疗组15例，予以股骨髁上牵引和延迟髋关节活动及负重。结果：手术治疗组47例中，41例获随访（87．2％）。Matta影像学评分：优18例，良19例，一般1例，差3例；Matta临床评分：优16例，良18例，一般5例，差2例。非手术治疗组15例中，11例获随访，其中1例死亡。Matta影像学评分：优2例，良2例，一般3例，差3例，Matta临床评分：优2例，良1例，一般4例，差3例。结论：对于有移位的髋臼骨折，手术治疗优于非手术治疗，是最佳的治疗方法。

Treatment of displaced acetabular fractures

Objective To improve the level of the treatment of displaced acetabular fracture. Methods From April 1993 to January 2000, 62 patients with displaced acetabular fracture were treated in our department. All cases were classified according to Judet classification, in whom 46 underwent open reduction and internal fixation through different approaches, 1 underwent total hip arthroplasty, and 15 non operative treatment. Results Forty-one of 47 patients who were treated surgically were followed up for an average of 46.2 months. According to Matta's clinical grade, 16 cases showed excellent results, 18 good, 5 fair, 2 poor. Eleven of 15 patients who were treated non operatively were followed up for an average of 37.8 months. According to clinical grade, 2 were excellent, 1 was good, 4 were fair, 3 poor. Conclusions Surgical intervention is needed for displaced acetabular fractures and the result is superior to that of non surgical intervention.