三叉扩展型入路治疗髋臼横断伴后壁骨折的体会

目的探讨三叉型扩展型入路骨盆重建钛板内固定治疗髋臼横断伴后壁骨折的可行性及临床效果。方法对26例髋臼横断伴后壁骨折患者采用三叉扩展型入路,应用专用骨盆髋臼复位器械行骨盆重建钛板和螺钉内固定治疗。结果骨折复位治疗按Matta标准评价:解剖复位20例,满意复位6例。术后随诊14～36个月,平均25个月,采用改良Merled Aubigne评分和Postel评分标准评价临床结果:优20例,良3例,一般2例,差1例。1例出现深部感染,1例发生股骨头坏死,1例发生异位骨化。结论采用三叉扩展型入路骨盆重建钛板治疗髋臼横断骨折伴后壁骨折,可使髋臼骨折达到最大限度复位及坚强固定,并获得理想的髋关节功能康复。

Experience of trident-type extended approach in the treatment of transverse acetabular fractures with posterior wall fractures

Objective To explore the feasibility and the clinical effects trident-type extended approach in the treatment of transverse acetabular fractures with posterior wall fractures. Methods 26 patients with transverse acetabular fractures and posterior wall fractures were treated with trident-type extended approach and pelvic acetabulum reposition device-specific for pelvic plate reconstruction and screw fixation. Results Fractures were evaluated by Matta standard: 20 cases with anatomic reposition, 6 cases with satisfactory reposition. All the patients were followed up for 14~36 months (with a mean of 25 months). The clinical effects were evaluated with improved Merled Aubigne and Postel score standarde: excellent in 20 cases, good in 3 cases, general in 2 cases and poor in 1 case. One patient was found with deep infection, and another one with femoral head necrosis and one with heterotopic ossification. Conclusion For transverse acetabular fractures with posterior wall fractures, pelvic reconstruction plate fixation with trident-type extended approach can achieve the maximum reposition and firm fixation, and get a good functional recovery of hip.