复杂类型髋臼骨折的手术治疗效果及其相关因素分析

目的]探讨复杂类型髋臼骨折手术治疗的效果并分析影响疗效的相关因素。【方法】选择2000年1月至2008年1月收治复杂类型髋臼骨折48例。术中采用Kocker—Lagenbach入路19例，髂腹股沟入路6例，前后联合入路23例，均采用A0重建钢板和螺钉内固定。评估其手术治疗效果。根据可能影响临床疗效的影响因素进行分组，采用Logistic回归分析影响疗效因素。【结果】本组全部获随访，随访时间10～68个月，平均29．7个月，本组术后功能优良率72．92％。年龄、手术时机、复位质量和创伤性关节炎与复杂类型髋白骨折术后功能评分结果有关（P〈0．05）。多因素分析结果显示手术时机、复位质量和创伤性骨关节炎是影响复杂类型髋臼骨折术后功能恢复的独立危险因素。【结论】切开复位内固定治疗复杂类型髋臼骨折疗效满意。手术时机、复位质量和创伤性骨关节炎是影响复杂类型髋臼骨折术后功能恢复的独立危险因素。

Operative Treatment of Complex Acetabular Fractures and Prognostic Factors Influencing the Outcome

Objective]To evaluate the results of operative treatment of complex acetabular fractures and to investigate its influence factors. Methods]From 2000 to 2008, 48 patients with complex acetabular fractures were treated. During operation, Kocker-Lagenbach approach was used in 19 cases, anterior ilioinguinal approach was applied for 6 cases and the combination of anterior and posterior approaches was performed on 23 cases. AO reconstructive plate and screw internal fixation were used in all the cases. Results]Forty eight cases were followed up for 10～68 months （average 29. 7 months）. The excellent and good rate reached 72.92%. Logistic regression analysis revealed that the time of operation, quality of fracture reduction and traumatic arthritis were independent risk factors affecting postoperative functional outcomes. Conclusion]Applying open reduction and internal fixation in the treatment of complex acetabular fractures has a satisfying therapeutic effect. The time of operation, quality of fracture reduction as well as traumatic arthritis are independent risk factors affecting the outcome of postoperative function.