Operative Treatment of Complex Acetabular Fractures_West China Medical Journal

Authors：

1.Department of Orthopedics, The Fifth People’s Hospital of Chengdu City, Chengdu 611130; 2.Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China;

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Keywords：

髋臼骨折; 分型; 手术入路; 骨折固定术

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目的:探讨复杂髋臼骨折的手术治疗方法及与疗效。方法:总结2002年2月～2007年12月对20例复杂髋臼骨折手术治疗的经验。其中男性14例,女性6例;年龄18～58岁,平均41岁。术前根据X线片及CT检查结果,所有骨折均按Letournel-Judet的方法进行分型、复合型20例。根据不同骨折类型,分别采用Kocher-Langenbeck入路10例,髂腹股沟入路4例及前后联合入路6例进行复位、固定。平均手术耗时3.5 h,术中平均失血900 mL。〖HTH〗结果〖HTSS〗:所有患者术后随访时间12～48个月,平均30个月。根据Matta影像学评分,解剖复位12例,复位满意4例,复位不满意4例。根据美国矫形外科学会髋关节功能评价标准,关节功能优6例,良8例,差6例,优良率为70%。解剖复位加满意复位的临床优良率为78.5%,而满意复位和差的复位的优良率为25%(P lt;0.05)。结论:不同的髋臼骨折需采用不同开放复位策略,其选择决定于髋臼骨折的类型,移位方向及其相应的手术入路。解剖复位、牢固固定、早期功能锻炼是提高疗效的关键。

Citation： GU Qishan,BAN Zhaolan,PENG Xiao,et al. Operative Treatment of Complex Acetabular Fractures. West China Medical Journal, 2009, 24(4): 840-842. doi: Copy

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2.	SIEBENROCK K A, GAUTIER E, ZIRAN BH, et al. Trochanteric flip osteotomy for cranial extension and muscle protection in acetabular fracture fixation using a Kocher-Langenbeck approach [J]. J Orthop Trauma,2006,20(1 Suppl):52-56..
3.	PETSATODIS G, ANTONARAKOS P, CHALIDIS B, et al. Surgically treated acetabular fractures via a single posterior approach with a follow-up of 2-10years[J]. Injury,2007,38(3):334-343.
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6.	周东生,王先泉,王伯珉,等.前后联合入路治疗复杂髋臼骨折(附46例报告)[J].中国矫形外科杂志,2004,12:170-172..
7.	STOCKLE U, HOFFMANN R, SUDKAMP N P, et al. Treatment of complex acetabular fractures through a modified extended iliofemoral approach[J]. Orthop Trauma,2002,16(4):220-230..
8.	蔡贤华,陈庄洪,徐永年,等.不同髋臼骨折手术入路选择的相关性因素分析[J].中国矫形外科杂志,2006.14(20):1526-1528..
9.	GLAS P Y, FESSY M H, CARRET J P, et al. Surgical treatment of acetabular fractures: outcome in a series of 60 consecutive cases [J]. Rev Chir Orthop Reparatrice Appar Mot,2001,87:529-538..
10.	吴新宝,王满宜,朱仕文,等.12例髋臼骨折手术治疗结果分析[J].中华创伤杂志,2002,18:80-84..

1. TORNETTA P 3RD, REILLY M, MATTA J. Acetabular fracture/dislocation[J]. Orthop Trauma,2002,16:139-142..
2. SIEBENROCK K A, GAUTIER E, ZIRAN BH, et al. Trochanteric flip osteotomy for cranial extension and muscle protection in acetabular fracture fixation using a Kocher-Langenbeck approach [J]. J Orthop Trauma,2006,20(1 Suppl):52-56..
3. PETSATODIS G, ANTONARAKOS P, CHALIDIS B, et al. Surgically treated acetabular fractures via a single posterior approach with a follow-up of 2-10years[J]. Injury,2007,38(3):334-343.
4. 李连欣,周东生,张连禄,等.手术治疗髋臼双柱骨折(附21例报告)[J].中国矫形外科杂志,2004,12(14):1045-1048..
5. 杨国敬,张力威,王伟良,等.移位髋臼骨折的内固定治疗[J].实用骨科杂志,2003,9(5):412-413..
6. 周东生,王先泉,王伯珉,等.前后联合入路治疗复杂髋臼骨折(附46例报告)[J].中国矫形外科杂志,2004,12:170-172..
7. STOCKLE U, HOFFMANN R, SUDKAMP N P, et al. Treatment of complex acetabular fractures through a modified extended iliofemoral approach[J]. Orthop Trauma,2002,16(4):220-230..
8. 蔡贤华,陈庄洪,徐永年,等.不同髋臼骨折手术入路选择的相关性因素分析[J].中国矫形外科杂志,2006.14(20):1526-1528..
9. GLAS P Y, FESSY M H, CARRET J P, et al. Surgical treatment of acetabular fractures: outcome in a series of 60 consecutive cases [J]. Rev Chir Orthop Reparatrice Appar Mot,2001,87:529-538..
10. 吴新宝,王满宜,朱仕文,等.12例髋臼骨折手术治疗结果分析[J].中华创伤杂志,2002,18:80-84..

West China Medical Journal

Operative Treatment of Complex Acetabular Fractures

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