髋臼骨折的内固定治疗(附39例分析)

目的 探讨髋臼骨折（acetabular fratures，AF）内固定的治疗和疗效相关因素。方法 回顾总结1996年8月至2004年12月39例有移位的髋臼骨折手术切开复位内固定的治疗经验。分别采用Kocher-Langenbeck入路、髂腹股沟入路和前后联合入路骨折复位，螺钉、钢丝或钢板内固定。结果 获4个月以上随访的32例患者，平均随访时间2．6年。参照美国矫形外科研究院评价标准，优25例（78．1％），良5例（15.6％），可2例（6．3％）。结论 正确分析骨折类型、选择恰当的手术时机和手术入路、良好的复位质量和牢固的内固定及早期有效的功能锻炼是提高髋臼骨折手术疗效的关键。

The internal fixation in management of acetabular fractures: Analysis of 39 cases

Objective To evaluate the effectiveness of internal fixation in management of acetabular fractures and to identify variables that were associated with outcomes. Methods Thirty-nine cases of acetebular fractures treated operatively from August 1996 to December 2004 were reviewed. The Kocher Langenbeck, ilioinguinal, combined anterior and posterior approach were used according to different fracture types. Screws, steel wires and plates were used for internal fixation. Results The average follow-up period was 2. 6 years (range from four months to eight years) . Based on the USA orthopaedic institution's standard, excellent result were found in 25 cases (78. 1%) good in five cases (15. 6%), fair in two cases (6. 3%) . Conclusion Correct analysis of the fracture types preoperatively, reasonable surgical timing and approach, satisfactory reduction, stable internal fixation and early exercise are essential for the treatment of acetabular fractures.