| 高肇篷,常波,孙法同,高明,贾代良,王海滨.切开复位内固定治疗髋臼骨折的手术技巧及疗效分析[J].济宁医学院学报,2020,43(1):27-31 |
| 切开复位内固定治疗髋臼骨折的手术技巧及疗效分析 |
| Surgical technique and curative effect analysis of open reduction and internal fixation for acetabular fracture |
| 投稿时间：2019-10-31 |
| DOI：10.3969/j.issn.1000-9760.2020.01.007 |
| 中文关键词: 髋臼骨折;内固定;手术技巧;疗效分析 |
| 英文关键词: Acetabular fracture;Internal fixation;Surgical technique;Efficacy analysis |
| 基金项目: |
| 作者 | 单位 | E-mail | | 高肇篷 | 济宁医学院临床医学院, 济宁 272013
济宁医学院附属医院, 济宁 272029 | | | 常波 | 济宁医学院临床医学院, 济宁 272013
济宁医学院附属医院, 济宁 272029 | | | 孙法同 | 济宁医学院临床医学院, 济宁 272013
济宁医学院附属医院, 济宁 272029 | | | 高明 | 济宁医学院附属医院, 济宁 272029 | | | 贾代良 | 济宁医学院临床医学院, 济宁 272013
济宁医学院附属医院, 济宁 272029 | | | 王海滨 | 济宁医学院附属医院, 济宁 272029 | wanghaibin99@163.com |
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| 中文摘要: |
| 目的 探讨切开复位内固定治疗髋臼骨折的手术技巧及疗效分析。方法 回顾性分析2016年1月至2018年1月济宁医学院附属医院共收治62例髋臼骨折患者的临床资料和随访结果，其中男性36例，女性26例，年龄18~83岁，平均45岁。根据Judet-Letournel分型，简单骨折39例，复杂骨折23例。62例患者根据骨折类型采用髂腹股沟入路（前路）、Kocher-Langenbenk入路（后路）或前后联合入路，均一期行切开复位重建钢板螺钉内固定术。结果 62例患者术后均获得12~40个月的随访（平均18.5个月），采用Matta标准评定骨折复位效果，62例患者获得解剖复位40例，满意复位22例。采用Matta改良的D'Aubigne和Postal评分标准评定临床效果，62例患者均达到优/良水平，优54例，良8例，其中1例患者术后出现浅表皮肤软组织感染，给予切口清创、换药后切口愈合良好；1例患者出现股骨头坏死，但髋关节功能良好，建议其远期可行人工股骨头置换术；2例患者术后出现下肢肌间静脉血栓，给予抗凝治疗后血栓消失。所有患者随访过程中X线片示内固定位置良好，经康复锻炼后髋关节功能恢复可。根据损伤程度，15例患者髋部出现不同程度异位骨化，下肢出现不同程度的感觉减退或异常。结论 切开复位内固定治疗髋臼骨折，恢复髋关节正常头臼关系，骨折端坚强内固定，恢复正常解剖位置，术后早期功能锻炼，使患者术后能够达到满意疗效。 |
| 英文摘要: |
| Objective To investigate the surgical technique and curative effect of open reduction and internal fixation for acetabular fractures.Methods The clinical data and follow-up results of 62 patients with acetabular fractures were treated retrospectively from January 2016 to January 2018 in the Affiliated Hospital of Jining Medical University.There were 36 males and 26 females,aged 18~83 years,with an average age of 45 years.According to the judet-Letournel classification,39 patients had simple fractures and 23 patients had complex fractures.According to the type of fracture,62 patients underwent sacral groin approach (anterior approach),Kocher-Langenbenk approach (posterior approach) or combined anterior approach.All patients underwent open reduction and reconstruction of plate screw internal fixation.Results All 62 patients were followed up for 12~40 months (mean value for 18.5 months).The fracture reduction was evaluated by Matta criteria.62 patients were treated with anatomical reduction (40) or satisfactory reduction(22).Using Matta's modified D'Aubigneand Postal The scores were used to evaluate the clinical effect.62 patients were achieved excellent(54)/good(8) level.One patient had superficial soft tissue infection after operation.The incision was debrided and the incision healed well after dressing.One patient developed femoral head necrosis,but the hip joint functioned well.It is recommended that the long-term feasible femoral head replacement was used.2 patients had postoperative intermuscular venous thrombosis,and the thrombus disappeared after anticoagulant therapy.During the follow-up of all patients,the X-ray films showed good internal fixation position,and the hip function recovered after rehabilitation exercise.According to the degree of injury,15 patients haddifferent degrees of heterotopic ossification in the hip,and different degrees of sensory decline or abnormality in the lower extremities.Conclusion The reduction and internal fixation for the treatment of acetabular fractures was carried out forrestoringthe normal head and ankle relationship of the hip joint.Strong internal fixation of the fracture end was done for restoringthe normal anatomical position.And early functional exercise was doneso that patients can achieve satisfactory results after surgery. |
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