髋臼骨折髋脱位的治疗

目的分析髋臼骨折合并脱位的非手术及手术治疗的随访结果。方法从１９７８年１月～１９９４年１月，治疗髋臼骨折髋脱位４５例。其分型是：前壁骨折６例，前柱骨折４例，后壁骨折９例，后柱骨折９例，前、后柱骨折１７例。结果牵引治疗２０例，平均随访３６．５个月，髋关节面复位优良率３５％（７／２０），髋关节功能优良率５０％（１０／２０），髋关节炎发生率５０％（１０／２０），异位骨化发生率１０％（２／２０）。手术治疗２５例，平均随访３０个月，髋关节面复位优良率８８％（２２／２５），髋关节功能优良率８４％（２１／２５），髋关节炎发生率４４％（１１／２５），异位骨化发生率４８％（１２／２５）。结论髋臼骨折髋脱位的治疗方法选择，应依据骨折类型及关节面移位程度决定，移位１ｍｍ者，牵引治疗，移位大于３ｍｍ者，应手术治疗

Treatment for Acetabular Fracture Combined with Hip Dislocation

Aim To evaluate the operation and nonoperation therapy results of acetabular fracture combined with hip dislocation. Methods From January 1978 to January 1994, 45 cases of acetabular fracture combined with hip dislocation were treated operatively on 25 cases and nonoperatively on 20 cases. According to Letournal classification, there were anterior column fracture 4 cases, anterior wall 6, posterior column 9, posterior wall 9, and anterior posterior column 17 cases. Results Followed up averagely for 36.5 months, in the nonoperative group, 7 cases showed good replacement, 10 good hip function, 10 hip arthritis and 2 ectopic ossification; and in the operative group, 22 cases showed good replacement, 21 good hip function, 11 hip arthritis, and 12 ectopic ossification. Conclusion It suggests that the treatment should base on the type of the fracture and the extent of joint surface displacement. In case of displacement for 1 3mm of joint surface, traction treatment may be employed, and in case of displacement greater than 3mm, operative treatment may get better results.