髋臼骨折手术并发症分析

目的探讨髋臼骨折手术并发症,提高髋臼骨折手术疗效。方法1998年6月~2006年12月手术治疗髋臼骨折95例,按Letounel-Judet分型,其中后壁骨折22例,后柱骨折8例,前壁骨折5例,前柱骨折6例,横形骨折15例,后柱伴后壁骨折8例,横形伴后壁骨折12例,"T"形骨折5例,前柱伴后半横形骨折3例,双柱骨折11例。根据不同骨折类型,手术分别采用Kocher-Langenbeck(K-L)入路52例,髂腹股沟入路35例,前后联合入路6例,髂股入路2例。对术后患者关节功能和主要并发症进行分析。结果所有病例平均随访26.8(6~48)个月。术后发生创伤性关节炎10例、股骨头坏死7例、异位骨化15例、坐骨神经损伤8例。结论正确选择手术时机、切口入路和内固定植入位置是减少髋臼骨折手术并发症的关键。

Analysis of Postoperative Complications of Acetabular Fracture

Objective To discuss the postoperative complication of acetabular fracture and to improve the surgical effect.Methods From June 1998 to December 2006,95 acetabular fracture patients were treated by operation.According to Letounel-Judet classification,the fractures were classified as posterior wall fracture in 22 cases,posterior column fracture in 8 cases,anterior wall fracture in 5 cases,anterior column fracture in 6 cases,transverse fracture in 15 cases,posterior column and posterior wall fracture in 8 cases,transverse and posterior wall fracture in 12 cases,T-shape fracture in 5 cases,anterior column and posterior hemi-transverse fracture in 3 cases,and double column fracture in 11 cases.Based on fracture type,different operative approaches were selected: 52 of Kocher-Langenbeck(K-L) approach,35 of ilioinguinal approach,6 of combined anterior and posterior approach,and 2 of iliofemoral approach.The joint function and complications were analyzed.Results All cases were followed up for 6 to 8 months(average 26.8).Postoperative complications were occurred in 10 of traumatic arthritis,7 of femoral head necrosis,15 of heterotopic ossification and 8 of sciatic nerve injury.Conclusion It is the key of appropriate selection of operative opportunity,approach and internal fixation position to reduce the postoperative complication of acetabular fracture.