| 手术治疗复杂髋臼骨折66例临床分析 |
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Received:March 31, 2006
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李文平 |
LI Wen-ping |
焦作市人民医院骨科,河南焦作454002 |
Department of Orthopaedics,the People’s Hospital of Jiaozuo,Jiaozuo 454002,Henan,China |
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| 靳方运 |
JIN Fang-yun |
焦作市人民医院骨科,河南焦作454002 |
Department of Orthopaedics,the People’s Hospital of Jiaozuo,Jiaozuo 454002,Henan,China |
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| 郭斌 |
GUO Bin |
焦作市人民医院骨科,河南焦作454002 |
Department of Orthopaedics,the People’s Hospital of Jiaozuo,Jiaozuo 454002,Henan,China |
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| 吴若丹 |
WU Ruo-dan |
焦作市人民医院骨科,河南焦作454002 |
Department of Orthopaedics,the People’s Hospital of Jiaozuo,Jiaozuo 454002,Henan,China |
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| 刘坤 |
LIU Kun |
焦作市人民医院骨科,河南焦作454002 |
Department of Orthopaedics,the People’s Hospital of Jiaozuo,Jiaozuo 454002,Henan,China |
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| 卢斌 |
LU Bin |
焦作市人民医院骨科,河南焦作454002 |
Department of Orthopaedics,the People’s Hospital of Jiaozuo,Jiaozuo 454002,Henan,China |
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| 白云鹤 |
BAI Yun-he |
焦作市人民医院骨科,河南焦作454002 |
Department of Orthopaedics,the People’s Hospital of Jiaozuo,Jiaozuo 454002,Henan,China |
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| 安灵芝 |
AN Ling-zhi |
焦作市人民医院骨科,河南焦作454002 |
Department of Orthopaedics,the People’s Hospital of Jiaozuo,Jiaozuo 454002,Henan,China |
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| 期刊信息：《中国骨伤》2007年20卷，第1期，第20-21页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:研究复杂髋臼骨折的手术适应证、手术时机、并发症及内固定方法的选择和操作要点。
方法:66例髋臼骨折患者中男58例,女8例;年龄22~61岁,平均35.5岁。新鲜骨折63例,陈旧性骨折3例。所有患者均采用切开复位内固定治疗,其中40例采用后方切口,20例前方切口,6例采用前后联合切口。36例采用髋臼钢板固定,26例采用单纯加压螺钉固定,4例采用钢板内固定结合克氏针固定。63例伤后5~10d内施行手术,3例伤后14d手术。术后穿“丁”字鞋2~3周,术后3~5d用CPM机逐渐被动关节功能锻炼,8~12周后恢复负重活动。
结果:随访58例,时间24~110个月,平均30个月。5例发生不同程度的异位骨化,4例发生股骨头坏死,2例发生深静脉栓塞。参照美国矫形外科研究院评价标准,优33例,良16例,可6例,差3例。优良率84.5%。
结论:复杂髋臼骨折的手术治疗要掌握手术适应证,把握良好的手术时机,选择合适的内固定方法,尽量采用无创技术,对改善临床疗效十分重要。 |
| [关键词]:髋骨折 髋臼 骨折固定术,内 |
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| Operative treatment of 66 patients with complex fracture of acetabulum |
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Abstract:
Objective:To study surgical indications,surgical opportunities,postoperative complications and choice of internal fixation methods and its performing key-points for complex fracture of acetabulum.
Methods:Sixty-six patients including(58 male) and 8 female,with an average age of 35.5 years ranging from 22 to 61 years,were recruited in the present study.(Among all) 66 patients 63 suffered from fresh fracture and 3 got old fracture.All the patients were treated with open reduction and internal fixation,in which 40 patients were treated with posterior approach,20 with anterior approach and 6 with posterior approach combination with anterior approach.Acetabular reconstruction plate fixation was used in 36 patients,simple compress screw in 26 patients and reconstruction plate internal fixation plus Kirchner fixation in 4 patients.The operation was performed in 63 patients within 5 to 10 days after injury,3 patients at 14th day after injury.After operation,T shape shoes were used for 2 to(3 weeks,)postoperative passive functional exercise was practiced 3 to 5 days after operation by using CPM,and weight bearing activity started from 8 to 12 weeks after operation.
Results:Fifty-eight patients were followed up with an average time of(30 months) ranging from 24 to 110 months.Postoperative complications included heterotopic ossification to different degree in(5 patients,)femoral head necrosis in 4 patients,and deep venous embolism in 2 patients.According to the criteria of USA Academy of Orthopedic Surgery,excellent results achieved in 33 patients,good in 16,fair in 6 and poor in 3.The excellent and good rate was 84.5%.
Conclusion:Follow points will be benefit to improve clinical effects in the treatment of complex fracture of acetabulum:grasp of surgical indications,correct choice of the operation time and suitable internal fixation method,as well as application of noninvasive technique. |
| KEYWORDS:Hip fractures Acetabulum Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李文平,靳方运,郭斌,吴若丹,刘坤,卢斌,白云鹤,安灵芝.手术治疗复杂髋臼骨折66例临床分析[J].中国骨伤,2007,20(1):20~21 |
| 英文格式: | LI Wen-ping,JIN Fang-yun,GUO Bin,WU Ruo-dan,LIU Kun,LU Bin,BAI Yun-he,AN Ling-zhi.Operative treatment of 66 patients with complex fracture of acetabulum[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(1):20~21 |
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