摘要
目的探讨切开复位内固定治疗髋臼后柱骨折的临床疗效。方法58例已经行切开复位内固定治疗的髋臼后柱不稳定性骨折患者，完全随访平均3年（2—9年），其中6例随访2年。采用Letoumel和Judet评分标准进行临床功能评估。分析患者骨折情况、影像学改变与功能的联系。结果手术后X线片见56例骨折这解剖复位，2例骨折复位不良。结果优：29例；良：21例；可：6例；差：2例；影像学结果：优：43例；良：7例；可：6例；差：2例。临床功能与影像学分级有很密切的联系。引起临床功能不满意的因素包括：髋关节脱位复位前超过24h，受伤年龄大于或等于60岁，涉及关节面的粉碎性骨折和骨质疏松。结论及时的髋关节复位对髋关节功能恢复是必要的。老年人骨折、骨质疏松和粉碎性骨折是髋关节功能恢复不满意的重要影响因素。解剖复位和内固定治疗髋臼后柱骨折是达到长期的优良临床疗效的治疗方法。
Objective To investigate the clinical outcomes of the fracture of the posterior wall of the acetabulum treated by open reduction and internal fixation. Methods Fifty - eight patients treated with open reduction and internal fixation of unstable fracture of the posterior wall of the acetabulum were studied. Mean follow -up periods were three years（ range, 2 - 9 years）. The functional outcomes were evaluated with the clinical grading system adopted by Letourmel and Judet. The realtionships between fracture condition, radiographic variables and functional outcomes were analyzed, Results Radiograph showed that anatomic reduction of the fracture was achieved in 56 patients and imperfect reduction in 2 patients. Follow - up clinic outcomes were as follows ： excellent in 29 patients, very good in 21 patients, good in 6 patients and poor in 2 patients. The radiographic results were excellent in 43 patients , good in 7 patients, fair in 6 patients and poor in 2 patients. There were significant association between the clinical outcomes and the final radiographic grade. Factors associated with poor clinical outcomes included a delay of more than 24 hours in reduction of associated hip dislocation , age of 60 years or older, comminuted fracture and osteoporosis. Conclusion Prompt reduction of associated hip dislocation is imperative for the recovery of hip function. The elderly patients, those with comminuted fracture and osteoporosis are more likely to have a poor clinical result. However, a high likelihood of a long term good to excellent results can be expected following anatomic reduction and internal fixation of the posterior wall of the scetabulum.
出处
《临床和实验医学杂志》
2006年第12期1928-1930,共3页
Journal of Clinical and Experimental Medicine
关键词
髋臼后柱骨折
解剖复位
内固定
The fracture of the posterior wall of the acetabulum
Anatomic reduction
Internal fixation
