不同髋臼骨折手术入路选择的相关性因素分析

目的]探讨髋臼骨折的手术治疗方法。方法]对1995年1月～2005年3月手术治疗的髋臼骨折进行回顾性分析，探讨影响手术入路选择的相关因素。结果]手术治疗107例，其中，采用Kocher—Langenbeck入路44例，扩大髂股入路5例，髂腹股沟或前侧扩大入路30例，前后联合入路28例。获解剖复位66例，满意复位36例，不满意复位5例。随访1～11a，采用美国矫形外科学会髋关节功能评估标准，总优良率89．72％。结论]骨折类型及其移位方向是确定手术入路的关键因素，骨折合并伤、手术时间及不同手术入路相关副损伤或并发症是其重要参考因素。

Relevancy factor analysis on the choice of operative approaches for different acetabular fractures

Objective] To study the surgical technique for the treatment of acetabular fractures. Method] Retrospective analysis on consecutive acetabular fractures operatively treated at our hospital from January 1995 to March 2005 was made to find out the correlation factors influenced on the operative approaches. Result] A total of 107 cases had surgery for an acetabular fracture in the meamtime. Of them, 44 were exposed through a Kocher-Langenbeck approach ,5 through an extended iliofemoral route, 30 through an ilioinguinal or an anterior extensile approach, and 28 through a combined anterior and posterior incisions. After operation, anatomic reduction was obtained in 66 cases, good reduction in 36, incomplete reduction in 5. According to AAOS score, the satisfactory rate was 89.72% after following-up 1 to 11 years. Conclusion ] To determine reasonable surgical exposure of an acetabular fracture, the key factors are fracture type and its displacement direction, and the important reference factors include associated injuries with the fracture, operative time and complications related to different operative routes.