移位髋臼骨折的手术治疗

目的探讨移位髋臼骨折的手术方法。方法对22例髋臼骨折按不同类型、不同手术入路分别用加压螺钉、重建钢板等予以内固定治疗。结果平均随访14个月(5~30个月)。术后发生1例伤口感染和1例坐骨神经牵拉伤,未发生血管损伤及深静脉栓塞。复位情况按Judet方法评估,达到解剖复位者18例,复位满意者4例。按美国矫形外科研究院标准评估疗效,优14例,良5例,可2例,差1例。结论重建钢板内固定治疗移位髋臼骨折是有效的方法,正确的骨折分型、手术切口的选择是复位成功的关键。

Surgical Treatment of Displaced Acetabular Fractures

Objective To explore a better surgical method for displaced acetabular fractures. Methods 22 patients with displaced acetabular fractures were treated with compressive screws or reconstructive plates according to the types of acetabular fractures. Results After operation, 1 case suffered from wound infection and sciatic nerve injury, but no blood vessel injury and deep vein thrombosis. According to the Judet assessment method, anatomical reduction was obtained in 18 cases, satisfied reduction in 4. All patients were followed up for 5 months to 2.5 years(an average of 14 months). According to AAOS score, excellent result was obtained in 14 cases, good in 5, fair in 2, and poor in 1. Conclusion Surgical treatment of reconstructive plate is a reliable alternation in displaced acetabular fracture. Complete image analysis, accurate selection of internal fixative device and appropriate operative time are important factors to good result.