[1]许阳凯 庄研 林焱斌△.三切口联合入路手术治疗复杂髋臼顶区粉碎性骨折22例[J].中国中医骨伤科杂志,2021,29(01):65-69.
　XU Yangkai ZHUANG Yan LIN Yanbin.Three Incisions Combined Approach in Treating 22 Patients withComminuted Fracture of Complex Acetabular Top Area[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(01):65-69.
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三切口联合入路手术治疗复杂髋臼顶区粉碎性骨折22例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年01期
页码:
65-69
栏目:
临床报道
出版日期:
2021-01-15

文章信息/Info

Title:
Three Incisions Combined Approach in Treating 22 Patients withComminuted Fracture of Complex Acetabular Top Area
文章编号:
1005-0205(2021)01-0065-05
作者:
许阳凯1 庄研1 林焱斌1△
Author(s):
XU Yangkai1 ZHUANG Yan1 LIN Yanbin1△
1Department of Orthopedic Trauma, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou 350007, China.
关键词:
髋臼骨折;  髋臼顶;  入路;  固定
Keywords:
acetabular fracture;  acetabular parietal;  approach;  fixation
分类号:
R683.42
文献标志码:
B
摘要:
目的:探讨三切口(K-L+髂翼+Stoppa)联合入路手术治疗复杂髋臼顶区粉碎性骨折的优势。方法:回顾性分析2014年10月至2019年8月收治的复杂髋臼顶区粉碎性骨折22例患者资料,其中男14例,女8例; 年龄23～71岁,平均46.8岁。采用Letournel-Judet髋臼骨折分型:双柱骨折12例,前柱+后方半横型骨折10例。受伤至手术时间7～21 d,平均12 d。所有患者手术均采用三切口(K-L+髂翼+Stoppa)联合入路,术中用重建钢板对粉碎的髋臼顶区进行十字固定。术后根据Matta影像学评分评估骨折复位情况,并根据改良的Merled Aubigne和Postel髋臼骨折临床结果评分标准评估髋关节功能。结果:本组病人22例,手术时间150～289 min(平均191 min),术中出血1 000～1 900 mL(平均1 400 mL),未出现切口感染、血管神经损伤等相关并发症,术后根据Matta影像学评分,骨折解剖复位14例,满意复位6例,不满意复位2例。术后随访6～17个月,患者功能根据改良的Merled Aubigne和Postel髋臼骨折临床结果评分标准,优10例,良5例,一般3例,差4例。结论:用三切口联合入路手术治疗复杂的髋臼顶粉碎性骨折,能有效显露髋臼骨折部区域并进行良好的复位; 十字交叉钢板固定能保证臼顶区骨折端的稳定,疗效良好。
Abstract:
To explore the advantage of three incisions(K-L+iliac wings+Stoppa)combined with approach in the treatment of comminuted fracture in the parietal area of complex acetabulum. Methods: 22 patients with the comminuted fracture of complex acetabular parietal area were retrospective analyzed in our hospital from October 2014 to August 2019. Among them, 14 were male, 8 were female, and the age were 23-71 years old(with 46.8 years old on average). There were 12 cases of double column fracture and 10 cases of half transverse fracture behind anterior column according to Letournel-Judet acetabular fracture type. The time from injury to operation was 7-21 d(12 d on average).Three incisions combined approach were used in all patients, and the comminuted acetabular apical region was crucified with reconstructed plate. The reduction of fracture was evaluated by Matta imaging score, and hip function was evaluated by the modified Merled Aubigne and Postel clinical results of acetabular fracture. Results: There were 22 patients in this group. The operation time was 150-289 min. The average was 191 min. The intraoperative blood loss was 1 000-1 900 mL,the average was 1 400 mL. There were not related complications such as incision infection or vascular nerve. Postoperatively, there were 14 cases of anatomic reduction, 6 cases were satisfactory reduction and 2 cases were unsatisfactory reduction according to the Matta imaging score. Postoperative follow-up was conducted for 6-17 months. There were 10 cases of excellent, 5 cases of good, 3 cases of general and 4 cases of poor according to the Merled Aubigne and Postel score criteria. Conclusion: Complex comminuted acetabular fractures with three incisions combined with approach can effectively reveal the area of acetabular fractures and perform good reduction. Cross plate fixation can effectively ensure the stability of the fracture end of the acetabular parietal, and the curative effect is good.

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备注/Memo

备注/Memo:
1厦门大学附属福州第二医院创伤骨科(福州,350007)
△通信作者 E-mail:13860603823@139.com
更新日期/Last Update: 2021-01-15