前后联合入路手术治疗复杂髋臼骨折

目的：探讨前后联合人路手术治疗复杂髋臼骨折的临床疗效。方法：分析2006年7月-2011年7月采用髂腹股沟入路联合kocher-langenbeck入路，切开复位重建钢板和螺钉固定治疗29例letournel＆Judet分型复杂髋臼骨折患者的临床资料。结果：手术时间2～4h，平均（2．5±1．3）h，术中失血量400—900ml，平均（600±180）ml，无切口感染和血管神经损伤，出现深静脉栓塞3例，切口I期愈合，无内固定松动及断裂，骨折愈合时间2～4个月，随访时间8～48个月，出现异位骨化5例，股骨头坏死1例。按matta复位标准，解剖复位22例，满意复位6例，不满意复位1例。髋关节功能按d’Aubigne—postel评分系统评定，优22例，良4例，中2例，差1例。结论：前后联合人路切开复位重建钢板和螺钉固定具有骨折复位准确、固定牢固方便的优点，是治疗复杂髋臼骨折的理想方法之一 。

Surgical Treatment of Complex Acetabular Fractures by Combined Anterior and Posterior Approach

Objective ： To investigate the surgical effect of complex acetabuiar fractures. Method ： From July 2006 to July 2011, 29 cases with complex acetahular fractures（letournel and Judet classification） were treated with open reduction and reconstructive plate fixation by combined ilioinguinal approach and koeher-langenbeek approach, 19 males and 10 females with age from 22 to 59 years old. Result ： The operation time was 2 to 4（2.5 ＋ 1.3） hours, the intraoperative blood loss was 400 to 900（600 ＋ 180）ml. No postoperative infection and vascular and nerve injury occurred, 3 case with deep vein thrombosis Were found and all wounds healed primarily, no loosening or breakage of screw, all cases got bony union in 2 to 4 months and were followed up for 8-48 months. Heterotopic ossification occurred in 5 cases and femoral head necrosis occurred in 1 case. According to Matta＇s reduction grade. There were anatomical reduction in 22 cases, satisfactory reduction in 6 cases and unsatisfactory reduction in 1 case. The function of hip was excellent in 22 cases, good in 4 cases, fair in 2 case and poor in 1 case, according to modified d＇ Aubigne-postel score system. Conclusion ： it is ideal therapy for complex acetabular fracture through open reduction and reconstructive plate fixation by combined anterior and posterior approach.