| 严重粉碎性髋臼骨折的手术治疗 |
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Received:January 26, 2005
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| 期刊信息：《中国骨伤》2005年18卷，第6期，第338-339页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨严重粉碎髋臼骨折手术治疗策略和方法。
方法:47例复杂髋臼骨折采用重建钢板和拉力螺钉内固定,按照Letournel分类,后柱合并后壁骨折5例,横形合并后壁骨折9例,T形骨折11例,双柱骨折合并后壁骨折16例,前柱合并后半横形骨折6例。合并髋脱位22例。KL入路11例,髂腹股沟入路16例,延长髂股入路2例,双入路18例。
结果:随访6～36个月,按照dAubignePostel标准,关节功能优34例,良10例,可3例,优良率93.60%。深部感染1例,医源性坐骨神经损伤1例,静脉血栓1例,中重度骨关节炎2例,股骨头缺血坏死1例,异位骨化7例。
结论:手术前明确骨折分类、手术时机适当、合适的入路和可靠的内固定及满意的复位是提高髋臼骨折治疗效果的关键。 |
| [关键词]:髋骨折 骨折固定术 内 骨折 粉碎性 |
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| Surgical treatment of severe comminuted acetabular fractures |
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Abstract:
Objective: To investigate the surgical strategies and methods of displaced complex acetabular fractures.
Methods:Forty-seven patients with acetabular fractures of complex type combined with dislocation were treated with open reduction and internal fixation with reconstruction plates and lag screws.Of the 47 cases,fractures of the posterior column and wall was found in 5 cases,transverse and posterior wall in 9 cases,T-shaped in 11 cases,anterior and hemitransverse in 6 cases,and the other 16 cases were both-column fractures combined with posterior wall fractures.Kocher-Langenbeck approach was adopted in 11 cases,ilio-inguinal approach in 16 cases,extended iliofemoral approach in 2 cases,and double approachs (K-L added with ilio-inguinal) in 18 cases.
Results:All patients underwent an average of 21 months(6～36 months) follow-up.According to d’Aubigne-Postel’s evaluation,34 patients achieved excellent results,10 good and 3 fair.The excellent and good rate was 93.60%.Complications included deep infection in 1 case,nerve injury in 1,deep venous thrombosis in 1,moderate or severe osteoarthritis in 2,avascular necrosis of the femoral head in 1,heterotopic ossfication occurring in 5 cases Brooker grade Ⅰ～Ⅱ and 2 cases grade Ⅲ.
Conclusion:Correct classification of fracture before operation,appropriate selection of operative approach and satisfactory fracture reduction and reliable internal fixation as well as timely operation are the key points to improve outcome of acetabular fracture. |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐彬,刘强.严重粉碎性髋臼骨折的手术治疗[J].中国骨伤,2005,18(6):338~339 |
| 英文格式: | XU Bin,LIU Qiang.Surgical treatment of severe comminuted acetabular fractures[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(6):338~339 |
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