手术治疗复杂性髋臼骨折16例

目的选择一种较为理想的治疗模式及术后并发症的防治以提高手术疗效.方法对16例复杂髋臼骨折按不同类型分别用空心双头螺纹钉、拉力螺钉等予以内固定治疗.主张应用联合切口显露术野.结果全部病例随访0.5～10年,平均6年.复位按Judet方法评估解剖复位11例、满意复位4例、不满意复位1例.髋关节功能按Harris评分系统进行评估优13例,良好2例,差1例.其中股骨头坏死并创伤性关节炎1例,异位骨化7例.结论复杂性髋臼骨折手术治疗是唯一最佳方法.术前准备和切开复位内固定尤其重要.手术无创操作,术后及时有效的药物治疗,主动或被动功能锻炼,是术后防止静脉栓塞、股骨头坏死及创伤性关节炎的较为理想的方法.

Operative treatment of comprehensive acetabular fracture (16 cases)

Objective To select one ideal method for the tre atm en t of complicated fracture of ac etabulum and prevention of postoperative com pli cations in order to improve the op eration effect.Methods Applied with open re duction and internal fixatio n using hollow screw threaded in head and tail or l ag screw,16cases of complicated fracture of acetabulum were treated according to different classification.using extensile ac etabulum approach is necessary .Results All cases in this group were followed-up for 6monthes to 10years w ith an average of 6years.According to judet' s reduction evaluation system,1 1ca ses were satisfied with anatomic reduction,fair in 4cases,poor in 1c as e.Harris criterion was used to assess the hip function after operation.The sco re result were excellent in 13cases,good in 2,poor in 1.Femoral head necr osis combined with trau-matic arthritis occurred in 1patien t,ectopia ossific ation in 1case.Conclusions Operative treatment of com-plicated fracture of a cetabulum is t he best method.Preoperation and open reduction fixation are impo rtant.No traumatic technique in operation,u sing effective drugs in time afte r op eration,initiative or passive functional training are ideal methods of pre ven tion of occurring venous embolism,f emoral head necrosis and traumatic arth ritis after operation.