摘要
目的探讨前路铁板加方形区螺钉联合改良后柱拉力螺钉内固定治疗涉及方形区的复杂髋臼骨折的临床疗效。方法 回顾性分析2010年3月至2013年1月收治的21例涉及方形区的髋臼骨折患者资料，男13例，女8例；年龄为19～65岁，平均41．2岁。骨折按Letournel分型：双柱骨折11例，T形骨折5例，前柱伴后半横形骨折5例.受伤至手术时间为4～16d，平均6．5d。所有患者均采用单一髂腹股沟入路，用钛板加方形Ⅸ螺钉联合改良后柱拉力螺钉进行内围定。结果小纰患者手术时间为120～270min．平均190mill；术中出血量最为300～l800mL，平均540mL根据改良Matta髋n骨折复位标准坪定骨折复位质鲢：解剖复似14例，满意复他6例，不满意复化1例。21例忠栉术后扶平均21．4个月（6～38个月）随访、末次随访时根槲改良的Merled’Aubign6-l，ostel功能评分标准泮定患髋功能：优12例，良5例，可3例，差1例，优良率为81．0％。、小组患者并发症发生率为23．8％（5／21），其中股外侧皮神经麻痹2例，肄位骨化l例，创伤性关H炎2例。结论前路钛板加力‘形区螺钉联合改良后佳拉力螺钉治疗涉及方形区的双住骨折、T彤骨折及前柱伴后半横形骨折jL仃创伤小、㈣定町靠、并发症发生率低等优点，临床效果良好，是治疗此类髋臼骨折的一种nr行方法。
Objective To summarize our clinical experience in tile treatment of complex quadrilat- eral fractures of the aeelabulum with anterior reconstruclion titanium plate plus trans-plate quadrilateral screws and improved posterior column lag screws. Methods From March 2010 to January 2013, 21 cases of quadrilateral fractures of the acetabulum were treated in our department. They were 13 males arrd 8 females, aged from 19 to 65 years （average, 41.2 years） . According to the Letournel classification, there were 11 double-column fractures, 5 T-shaped ones and 5 arrterior column plus posterior hemi-transverse ones. The average time from injury to operation was 6. 5 days （from 4 to 16 days） . All cases were treated via tire il- iuinguinal approach with internal fixation with reconstruetinn titanium plate plus trans-plate quadrilateral serews and improved posterior column lag screws. Results The operation time for this series ranged from 120 to 270 minutes, averaging 190 minutes. The intraoperative blood bleeding ranged from 300 to 1 800 mL, with an average of 540 mL. By the modified Matta evaluation system, 14 cases had anatomic reduction, 6 cases satis- factory reduction, and one dissatisfaeto~＇ reduction. The 21 patients were followed up from 6 to 38 months （average, 21.4 months） . According to the improved Merled＇ Aubign6-Postel criteria at the last follow-up, 12 cases were rated as exeellent, 5 good, fair 3 cases, amt one poor, giving an excellent-to-good rate of 81.0 %. The eomplic, ation rate for this series was 23.8% （5/21）, inch,ling 2 cases of lateral femoral cutaneous nerve injury, one case of heterotopic ossification and 2 cases of traumatic arthritis. Conclusion In the treatment of qnadrilateral fractures of double columns, T-shaped fractures and anterior cohmm plus posterior Ire- nil-transverse fraelures, internal fixation with anterior reconstruction titanium plate plus lrans-plate quadrilal- eral screws and improwed posterior column lag screws is really an optimal choice, because it ean lead to limited invasion, rigid fixation, fewer complications, and satisfactory outcomes.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2014年第2期110-114,共5页
Chinese Journal of Orthopaedic Trauma
关键词
髋臼
骨折
骨折固定术
内
骨钉
骨板
Aeelabulum
Fraetures, bone
Frature fixation internal
Bone nails
Bone plales
