| 髋臼骨折不同移位类型对手术治疗效果的影响 |
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投稿时间：2015-07-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 董伊隆 |
DONG Yi-long |
温州医科大学附属第三医院骨科, 浙江 瑞安 325200 |
Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang, China |
dongyilongde@163.com |
| 钱约男 |
QIAN Yue-nan |
温州医科大学附属第三医院骨科, 浙江 瑞安 325200 |
Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang, China |
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| 刘良乐 |
LIU Liang-le |
温州医科大学附属第三医院骨科, 浙江 瑞安 325200 |
Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang, China |
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| 张元勋 |
ZHANG Yuan-xun |
温州医科大学附属第三医院骨科, 浙江 瑞安 325200 |
Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang, China |
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| 蔡春元 |
CAI Chun-yuan |
温州医科大学附属第三医院骨科, 浙江 瑞安 325200 |
Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang, China |
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| 杨国敬 |
YANG Guo-jing |
温州医科大学附属第三医院骨科, 浙江 瑞安 325200 |
Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325200, Zhejiang, China |
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| 期刊信息：《中国骨伤》2016年，第29卷，第4期，第298-301页 |
| DOI：10.3969/j.issn.1003-0034.2016.04.002 |
| 基金项目: |
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中文摘要:
目的:探讨髋臼骨折术后的复位质量,并且分析复位质量对髋臼骨折术后临床效果的影响.
方法:回顾分析自2008年1月至2013年12月采用切开复位内固定术治疗并获得随访的77例髋臼骨折患者,其中男45例,女32例;年龄19~78岁,平均42.4岁.按照Judet-Letournel分型:简单骨折41例,复杂骨折36例.患者受伤至手术时间<2周50例,>2周27例.采用Matta复位标准对患者术后进行复位质量和远期影像学评价;根据改良d'Aubigné-Postel 评分标准对患者的髋关节临床功能行评估,分析复位质量与临床结果的相关性.
结果:全部患者术后获得随访,时间12~34个月,平均17个月.手术时间2.5~10.5 h,平均4.5 h;术中出血量400~5 500 ml,平均1 652 ml.术后切口均甲级愈合,未出现切口感染.末次随访时d'Aubigné-Postel评分:疼痛4.60±1.35,行走4.80±1.14,关节活动度4.50±1.37,总分14.60±2.73;其中优12例,良43例,可15例,差7例,优良率71.4%(55/77).单因素分析结果显示复位质量与手术疗效有关(P<0.05).内旋阶梯状移位和外旋阶梯状移位同手术疗效间存在显着相关性(P<0.05).
结论:复位质量是影响手术疗效的重要因素,而阶梯状移位对髋臼骨折术后疗效的影响明显,故主张手术时要注意阶梯状移位、尽量达到解剖复位,以最大限度地恢复髋臼骨折术后患者的功能. |
| 【关键词】髋臼 骨折 骨折固定术,内 治疗结果 |
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| Effect of the different types of displacement of acetabular fractures on surgical treatment outcomes |
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ABSTRACT
Objective:To investigate the quality of reduction after surgical treatment of acetabular,and to analyze the influence of the quality of reduction on postoperative clinical effect of the acetabular fracture.
Methods:From January 2008 to December 2013,77 patients with acetabulum fracture treated in our hospital were enrolled in the retrospective study,including 45 males and 32 females,with an average age of 42.4 years old ranging from 19 to 78 years old. According to Judet-Letourne type: 41 cases belonged to simple fractures,36 cases belonged to complex fractures. Fifty patients were received operation within 2 weeks,and 27 patients received operation for more than 2 weeks. Postoperative reduction quality and long-term radio-graphic results were evaluated according to Matta score. The modified d'Aubigné-Postel hip scoring system was used for evaluating the functionaI outcomes. Correlation of clinical results and reduction quality was analyzed.
Results:The average period of follow-up was 17 months(ranged from 12 to 34 months). The average time of operation was 4.5 h(ranged from 2.5 to 10.5 h),and the average bleeding during operation was 1 652 ml(ranged from 400 to 5 500 ml). There was no incision infection after operation. At the last follow-up,the modified d'Aubigné-Postel clinical score was 4.60±1.35 of pain,4.80±1.14 of walking,4.50±1.37 of the activity of the joints,and 14.60± 2.73 in total; 12 cases were excellent,43 cases were good,15 cases were moderate,and 7 cases were poor,the excellent and good rate was 71.4%(55/77). Single factor analysis showed that quality of reduction was associated with curative effect(P<0.05). Internal rotation and external rotation displacement of ladder shift correlated significantly with operation curative effect(P<0.05).
Conclusion:The analysis showed that reduction quality is the independent factors affecting clinical outcomes. But the step-off displacement on the curative effect of acetabular fracture is obvious. The reduction quality is relatively controllable factors. Therefore,in order to obtain good clinical outcome anatomical reduction should be achieved. |
| KEY WORDS Acetabulum Fractures Fracture fixation,internal Treatment outcome |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 董伊隆,钱约男,刘良乐,张元勋,蔡春元,杨国敬.髋臼骨折不同移位类型对手术治疗效果的影响[J].中国骨伤,2016,29(4):298~301 |
| 英文格式: | DONG Yi-long,QIAN Yue-nan,LIU Liang-le,ZHANG Yuan-xun,CAI Chun-yuan,YANG Guo-jing.Effect of the different types of displacement of acetabular fractures on surgical treatment outcomes[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(4):298~301 |
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