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双钢板内固定治疗髋臼骨折
Hits: 1743   Download times: 1140   Received:January 19, 2005    
作者Author单位UnitE-Mail
卢巧华 LU Qiao-hua 江山市人民医院骨科,浙江江山324100 Department of Orthopaedics,the People’s Hospital of Jiangshan,Jiangshan 324100,Zhejiang,China Qiaohuababa@126.com 
吴国正 WU Guo-zheng 江山市人民医院骨科,浙江江山324100 Department of Orthopaedics,the People’s Hospital of Jiangshan,Jiangshan 324100,Zhejiang,China  
期刊信息:《中国骨伤》2005年18卷,第12期,第717-718页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:研究高暴力所致髋臼复杂性骨折早期进行切开复位、双钢板内固定治疗的可行性及疗效。

方法:本组28例,男19例,女9例;年龄22~56岁,平均36.8岁。根据髋臼骨折Letournel-Judet分类:Ⅲ型10例,Ⅳ型6例,Ⅴ型8例,Ⅹ型4例。其中18例并存不同程度的髋关节中心型脱位。原发性坐骨神经损伤4例。早期采用髂腹股沟联合入路、直视下整复骨折,双钢板行髂耻弓及髂坐弓固定。3 d后行被动关节活动和静力肌肉等张收缩锻炼;2周后行主动伸屈髋关节锻炼,并可逐渐扶拐不负重行走。

结果:28例获得6个月以上随访,骨折全部愈合,根据改良的d`Aubigne-Postel功能评定标准,本组优19例,良6例,一般1例,差2例。关节活动范围获得满意恢复,活动范围百分数24例为95%~100%;80%~95%2例;2例坐骨神经损伤,1年后未恢复,而<50%。

结论:复杂性髋臼骨折早期行坚强、可靠内固定,可取得理想的疗效。掌握手术时机、注意操作技巧可避免并发症的发生。
[关键词]:髋骨折  骨折固定术,内  骨科手术方法
 
Treatment of acetabulum fractures with dual-plate internal fixation
Abstract:

Objective: To study probability and therapeutic effects of timely open plus reduction and dual-plate internal fixation for the treatment of complex acetabular fractures casused by intense violence.

Methods:Twenty-eight patients(male 19 and female 9;aged from 22 to 56 years,averagely 36.8)were reviewed in the study.According to Letournel-Judet’s classification,10 patients were type Ⅲ fractures,6 type Ⅳ,8 type Ⅴ and 4 type Ⅹ.In addition,18 patients were accompanied with central dislocations of the hip joint to different extent,and 4 with primary sciatic nerve damages.In the early stage of treatment,Kocher-langenbeck approach,fracture cleaning-up and reduction under direct vision and dual-plate fixation on arcus iliopectineus and arcus ilioischineus were performed.Passive joint-movement exercises and muscle isotonic contraction exercises under static force were added from 3rd day after the operation.Active extension-flexion exercises and gradually walk without load under the assistance of crutches started from 2nd week after operation.

Results:All the patients were followed up above 6 months and the fractures healed completely.According to modified d`Aubigne-Postel standard,19 patients had excellent results,6 good,1 poor and 2 bad.The excellent-and-good rate was 89.2%.The range of motion was well recovered.In 24 patients,the percentages of the range of motion were between 95% and 100%,2 patients between 80% and 95%.Other 2 patients with injuries of sciatic nerve had not been recovered within 1 year,and the percentage was less than 50%.



Conclusion:
Using stable and dependable internal fixation in the early stage of complex acetabular fractures is helpful to obtain ideal therapeutic effects.Both proper choice of operation time and operational techniques are important in the prevention from complications.
KEYWORDS:Hip fractures  Fracture fixation,internal  Orthopaedics operative methods
 
引用本文,请按以下格式著录参考文献:
中文格式:卢巧华,吴国正.双钢板内固定治疗髋臼骨折[J].中国骨伤,2005,18(12):717~718
英文格式:LU Qiao-hua,WU Guo-zheng.Treatment of acetabulum fractures with dual-plate internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(12):717~718
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