髋臼骨折治疗方法选择及疗效分析
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作者Author单位AddressE-Mail
刘日光 LIU Ri-guang 贵阳医学院附属医院骨科, 贵州贵阳550004, Department of Orthopaedics Affiliated Hospital of Guiyang Medical College,Guizhou Guiyang,550004,China liuriguang5629519@163.net 
尹培荣 YIN Pei-rong 贵阳医学院附属医院骨科, 贵州贵阳550005, Department of Orthopaedics Affiliated Hospital of Guiyang Medical College,Guizhou Guiyang,550004,China  
杨启友 YANG Qi-you 贵阳医学院附属医院骨科, 贵州贵阳550006, Department of Orthopaedics Affiliated Hospital of Guiyang Medical College,Guizhou Guiyang,550004,China  
杨述华 YANG Shu-hua.  华中科技大学同济医学院协和医院  
期刊信息:《中国骨伤》2005年,第18卷,第2期,第69-71页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:探讨髋臼骨折的分类、治疗方法与临床疗效的关系。

方法:从1993年6月至2002年7月,共收治51例髋臼骨折患者,其中30例髋臼骨折采用骨牵引治疗,牵引时间为4~6周,3个月后开始负重;21例采用切开复位内固定,术前均作骨牵引,术后鼓励活动肌肉和关节,结合使用CPM机进行持续被动功能活动,2~3个月开始逐渐负重。

结果:44例获15~10年随访,其中骨牵引治疗组25例,手术治疗组19例。疗效评定参照美国矫形外科学会提出的髋关节功能评价方法,采用非手术治疗组疗效优11例,良8例,可2例,差4例;采用手术治疗组疗效优10例,良6例,可1例,差2例。

结论:Letournel分类中只有单纯的前后壁或前后柱骨折,骨折块小而未累及髋臼负重区的骨折,分离移位<3mm,才适用牵引治疗;而对于复杂的髋臼骨折或分离移位>3mm的单纯性骨折,只有应用手术治疗才可能有效恢复髋臼与股骨头的对合,提高临床疗效。
【关键词】髋臼  骨折  牵引术  外科手术
 
Selection of therapeutic treatment for acetabular fracture and the analyses on their effectiveness
ABSTRACT  

Objective: To study relations of clinical effects with the classification and the choice of therapy in the acetabular fractures.

Methods: From June 1993 to July 2002,thirty patients of acetabular fractures were treated with simple bone traction and twenty one patients were treated with open reduction and internal fixation.The traction was applied for 3~4 weeks.The exercises of joints were encouraged and weight bearing was permitted after three months in all patients.

Results: Forty four patients were followed up for 1 5~10 years.Twenty five patients of them were in the traction group and nineteen patients were in the operation group.Based on AAOS evaluation,eleven patients were excellent,eight were good,two were fair and four were poor in the traction group.However,in the operation group ten patients were excellent,six were good,one was fair and two were poor.

Conclusion: According to the Letournel classification,open reduction and internal fixation is indicated for treatment of anterior and (or) posterior wall with bigger fragment (>40%),the weight bearing area is involved with wider gap and (or) displacement(>3 mm).
KEY WORDS  AcetabulumFracturesTractionSurgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:刘日光,尹培荣,杨启友,杨述华.髋臼骨折治疗方法选择及疗效分析[J].中国骨伤,2005,18(2):69~71
英文格式:LIU Ri-guang,YIN Pei-rong,YANG Qi-you,YANG Shu-hua. .Selection of therapeutic treatment for acetabular fracture and the analyses on their effectiveness[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(2):69~71
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