复合型髋臼骨折治疗的临床研究

目的：探讨采用手术方法治疗复合型髋臼骨折的疗效。方法：回顾分析58例患者，按Letournel分类，后壁伴后柱骨折15例，横形伴后壁骨折17例，T型骨折6例，双柱骨折12例，前柱骨折伴后半横形骨折8例。根据不同的骨折类型，选择髂腹股沟入路7例，Kocher—Langenbech入路9例，联合入路31例，延长髂股入路11例，全部采用重建钢板进行固定。结果：58例患者，平均随访时间14．6个月，根据Matta评分，优41例，良9例，可7例，差1例。异位骨化3例，中重度创伤性关节炎2例，股骨头坏死1例，骨折块有移位2例。结论：术前正确分析骨折类型，选择合适的手术入路及及时的手术是提高髋臼骨折治疗效果的关键。

Clinical study of the treatment of complex acetabular fracture (attached with a report of 58 cases)

Objective: To explore the effect of the surgical treatment for the complex acetabular fracture. Methods: A retrospective analysis of 58 patients was performed.All the patients were classified according to the Letournel rules.Posterior wall and posterior column fracture 15,transverse and posterior wall frcture 17,T type frature 6,both columns fracture 12,anterior column and posterior transverse fracture 8.The choice of surgical approach was basesd on the individual fracture which including ilioinguinal approach 7,Kocher Langenbech approach 9,combined approach 31,extended iliofemoral approach 11.All the patients were fixed with reconstruction plates. Results: The average followed time was 14 6 months.The results were assessed by Matta scores,excellent 41,good 9,fair 7,poor 1.The rate of excellent and good was 86%.The heterotopic ossification 3,medium and severe traumatic arthritis 2,femoral head necrosis 1,displaced fracture fragment 2. Conclusion: The key to increase the effectiveness of surgical treatment of acetabular fracture is followed with the correct preoperative classification of the facture,the choice of appropriate surgical approach and time.