[1]钱钧 王浩宇 方智敏.腹直肌外侧入路结合后柱内固定治疗复杂髋臼骨折80例[J].中国中医骨伤科杂志,2022,30(08):64-67.
　QIAN Jun WANG Haoyu FANG Zhimin.Clinical Report of 80 Cases of Complex Acetabular Fractures Treated with Lateral Rectus Abdominis Approach Combined withPosterior Column Internal Fixation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(08):64-67.
点击复制

腹直肌外侧入路结合后柱内固定治疗复杂髋臼骨折80例()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年08期
页码:
64-67
栏目:
临床报道
出版日期:
2022-08-15

文章信息/Info

Title:
Clinical Report of 80 Cases of Complex Acetabular Fractures Treated with Lateral Rectus Abdominis Approach Combined withPosterior Column Internal Fixation
文章编号:
1005-0205(2022)08-0064-04
作者:
钱钧1 王浩宇1 方智敏1
1温州医科大学附属衢州医院(衢州市人民医院)骨科(浙江 衢州,324000)
Author(s):
QIAN Jun1 WANG Haoyu1 FANG Zhimin1
1Department of Orthopedics,Quzhou Hospital Affiliated to Wenzhou Medical University(Quzhou People's Hospital),Quzhou 324000,Zhejiang China.
关键词:
髋臼骨折;  腹直肌外侧入路;  通道后柱内固定;  并发症
Keywords:
acetabular fractures;  lateral rectus abdominis approach;  channel posterior column internal fixation;  complications
分类号:
R683.42
文献标志码:
B
摘要:
目的:探究经腹直肌外侧入路结合通道后柱内固定治疗复杂髋臼骨折患者对围手术期指标与并发症的影响。方法:选取2018年3月至2021年3月在本院进行手术治疗的复杂髋臼骨折患者80例。患者均行腹直肌外侧入路结合通道后柱内固定治疗。术后随访6个月,记录患者围手术期指标、髋关节功能、骨折复位、生活质量及术后并发症情况。结果:所有患者均顺利完成手术,且患者手术时间(2.14±0.32)h,术中失血量为(316.26±48.05)mL、切口长度为(9.10±0.52)cm、引流管拔除时间为(1.51±0.42)d、术后引流量为(120.52±21.64)mL。经随访,患者均无神经损害症状加重,均未出现肺部感染、肺不张、胸腔积液、泌尿系感染和症状性血栓等并发症。Matta影像学评估复位情况,其中优25例、良31例、中11例、差13例,优良率为83.75%。术后6个月,患者的Harris评分及SF-36评分均显著高于术前,差异均具有统计学意义(P<0.05)。结论:经腹直肌外侧入路结合通道后柱内固定治疗复杂髋臼骨折的复位效果好,可有效改善患者髋关节功能,提高患者生活质量,且该术安全性高,术后并发症少。
Abstract:
Objective:To explore the influence of translateral rectus abdominis approach combined with posterior column internal fixation on the treatment of patients with complex acetabular fractures on perioperative indicators and complications.Methods:A total of 80 patients with complex acetabular fractures who underwent surgical treatment in hospital from March 2018 to March 2021 were selected as the research subjects.All patients underwent lateral rectus abdominis approach combined with channel posterior column internal fixation.The patients were followed up for 6 months,and the perioperative indexes,hip joint function,fracture reduction,quality of life and postoperative complications were recorded.Results:All patients successfully completed the operation,and the operation time of the patients was(2.14±0.32)h,the intraoperative blood loss was(316.26±48.05)mL,the incision length was(9.10±0.52)cm,the drainage tube removal time was(1.51±0.42)d,The postoperative drainage volume was(120.52±21.64)mL.None of the patients had worsening symptoms of neurological damage after follow-up,and no complications such as pulmonary infection,atelectasis,pleural effusion,urinary tract infection and symptomatic thrombosis occurred.And Matta imaging evaluation of reduction showed 25 cases were excellent,31 cases were good,11 cases were moderate,and 13 cases were poor,with an excellent and good rate of 83.75%.In addition,the Harris score and SF-36 score of patients 6 months after operation were significantly higher than those before operation,and the difference was statistically significant(P<0.05).Conclusion:Translateral rectus abdominis approach combined with channel posterior internal fixation has a good reduction efficacy on the treatment of complex acetabular fractures,which can effectively improve the function of the patient's hip joint and improve the quality of life of the patient.The operation is safe and has fewer postoperative complications.

参考文献/References:

[1] 陈栋,朱峰,龚杰,等.改良Stoppa术治疗骨盆髋臼骨折围术期指标及术后血清应激指标观察[J].实用临床医药杂志,2021,25(8):92-95.
[2] 姜宇,荣晓旭,沈昳忞.肥胖对经皮穿刺辅助的微创髋关节置换术临床疗效的影响[J].中国基层医药,2019,26(13):1537-1540.
[3] CANESSA C E,CAL F B,VIGLIONE N B,et al.Transpelvic oblique rectus abdominis myocutaneous flap with preservation of the rectus sheath[J].Dis Colon Rectum,2020,63(9):1328-1333.
[4] 程辉光,张育民,段宁,等.3D打印技术在髋臼骨折患者诊治中的应用效果及对肢体功能的影响研究[J].河北医科大学学报,2018,39(2):164-166.
[5] 姚运峰,薛晨曦,孙一松,等.两种前后联合入路治疗复杂髋臼骨折的疗效比较[J].中国修复重建外科杂志,2018,32(12):1512-1517.
[6] 中华医学会.临床诊疗指南·骨科分册[M].北京:人民卫生出版社,2009.
[7] MATTA J M.Fractures of the acetabulum:accuracy of reduction and clinical results inpatients managed operatively within three weeks after the injury[J].J Bone Joint Surg Am,1996,78(11):1632-1645.
[8] WENZEL L,VON RÜDEN C,THANNHEIMER A,et al.The pararectus approach in acetabular surgery:radiological and clinical outcome[J].J Orthop Trauma,2020,34(2):82-88.
[9] 杨勇,邱志杰,徐红革,等.打印与虚拟手术设计在髋臼骨折手术治疗中的应用[J].蚌埠医学院学报,2021,46(8):1054-1057.
[10] 许鹏雍,陈俊,班付伟,等.改良Stoppa切口入路与腹直肌外侧入路治疗骨盆髋臼骨折的临床疗效比较[J].临床和实验医学杂志,2019,18(3):299-302.
[11] 邵晏清,黄启治,钟锡鸿,等.经腹直肌外侧及改良Stoppa两种入路方式治疗髋臼骨折的分析[J].创伤外科杂志,2019,21(1):40-43.
[12] 麦奇光,陈煜辉,李涛,等.直接后方入路经皮后柱通道螺钉及钢板固定治疗髋臼后方粉碎性骨折[J].中华骨科杂志,2021,41(19):1426-1433.
[13] 龚大伟,曾卫平,王良恩,等.腹直肌外侧入路治疗复杂骨盆、髋臼骨折的临床疗效研究[J].四川医学,2020,41(9):950-955.
[14] 朱现玮,严飞,王黎明,等.经单一腹直肌旁入路结合螺钉固定治疗累及髋臼前、后柱的复杂髋臼骨折[J].实用骨科杂志,2020,26(1):63-67.
[15] 刘家国,尚锋,罗斌,等.腹直肌外侧入路钢板结合后柱拉力螺钉固定治疗涉及后柱的髋臼骨折[J].中华创伤骨科杂志,2019,21(6):490-497.

备注/Memo

备注/Memo:
基金项目:衢州市科技局指导性项目(2019ASA90155)
更新日期/Last Update: 2022-08-15