髋关节骨折脱位22例报告

作者在1987年1月至1994年3月间收治髋关节骨折脱位22例,占同期收治62例髋关节后脱位的34.9%.按改良的Stward分型,Ⅰ型2列,Ⅱ型5例,Ⅲ型4例,Ⅳ型6例,Ⅴ型5例.新鲜伤16例,陈旧伤6例.均为闭合性.误漏诊3例.对Ⅰ、Ⅲ型采取保守治疗;对Ⅱ、Ⅳ、Ⅴ型大部分采取手术治疗.其中16例随访平均3年8个月,疗效11例满意,3例基本满意,2例不满意,满意与基本满意率为87.5%.对髋关节骨折脱位的分型、治疗方法及内固定方法进行了讨论,主张有选择和有节制的手法复位,手法复位失败及陈旧性者采取早期切开复位及内固定.介绍一种可吸收性聚乙交酯(SR—PGA)螺钉及固定棒治疗股骨头骨折,认为此种可吸收性材料不需二次手术取出,对关节内骨折经软骨内固定具有特殊的优越性.

Fracture- Dislocation of Hip Joint (A Report of 22 Cases)

Between January 1987 to March 1993,the authors had treated 22 cases with fracture-dislocatiou of hip joints (accounting for 34. 9% of 62 cases hip joint posterior-dislocation at this time). A modified Stward's classification was adopted:2 patients had type I injuries,5 had type II ,4 type III ,6 type IV and 5 type V . Of 22 cases, 16 cases were the fresh injuries and 6 cases were the old one. All cases were closed injuries. Three cases were misdiag-nozed. Type I and III injuries were treated with nonoperation,Most of type II , IV and V were treated by operation. Sixteen of the 22 cases followed - up for an average 3. 8 years,11 cases had satisfactory results,3 cases had generally satisfactory results,2 cases had poor results misdiagnozed . The satisfactory and the generally satisfactory results were obtained in 87. 5% of the patients. The article discussed the classification, therapy and methods of internal fixation of fracture- dislocation of hip joint. It is suggested that the closed reduction should be limitedly selected. The open reduction and internal fixation should be adopted to the failed closed reduction and the old injuries. A absorbable self-reinforced polyglycilid SR -PGA screw and solid rod were introduced to treat the fracture of femur head. The authors maintain that the absorbable materials don' t need a secondary operation and have a specific advantage to fix the articular fracture by way of the articular cartilage.