重建钢板治疗不稳定骨盆骨折并移位髋臼骨折

目的探讨不稳定骨盆骨折并移位髋臼骨折手术治疗效果。方法自1998年2月至2002年10月，对22例不稳定骨盆骨折并移位髋臼骨折采用骨盆重建钢板和螺钉进行复位和内固定，20例通过髂腹股沟入路手术治疗，其中9例加用Kocher-Langenbeck入路，另2例采用延长S—P入路。术后早期功能锻练。结果平均随诊时间为16个月(6—60个月)，骨盆骨折均获复位。根据Matta影像学评分，髋臼解剖和复位满意20例，不满意2例。用改良的Merled’Aubigne和Postel评分系统评估临床结果，优良16例，一般4例，差2例。一例发生异位骨化，无一例感染及不愈合。结论应用骨盆重建钢板手术治疗不稳定骨盆骨折并移位髋臼骨折，可有效复位固定骨折，矫正畸形，重建髋臼、骨盆环的稳定性，恢复髋臼关节面的平整和正常头臼关系，疗效满意。

Surgical Treatment of Unstable Pelvic Fractures and Displaced Acetabular Fractures by Pelvic Reconstructive Plates and Screws.

Objective To study the results of operative treatment of unstable pelvic fractures and displaced acetabular fractures by pelvic reconstructive plates. Methods From February 1998 of October 2002, fracture reduction and fixation were carried out with pelvic reconstructive plates and screws in 22 cases of unstable pelvic fractures and displaced acetabular fractures. 20 cases had undergone surgical treatment through the ilionguinal approach, the Kocher-langenbeck approach was added in 9, 2 cases were performed through the extensile S-P incision. The functional rehabilitation program was carried out early after operation. Results The average follow-up period was 16 months (from 6 to 60 months), all pelvic fractures were reduced satisfactorily. Acetabular fractures were revealed anatomical and satisfactory reduction in 20 cases, unsatisfactory reduction in 2 cases. The clinical evaluation was done with the modified Merle d' Aubigne and Postel clinical grading system and showed excellent and good result in 16 cases, fair in 4 cases, poor in 2, Heterotopic ossification occurred in a case. lnfection and non-union were not found in this series. Conclusion Astable pelvis and acetabular could be reconstructed, and the acetabular-femoral head relationship re-established by offective open reduction and internal fixation with pelvic reconstructive plates and screws.