| 陈旧性髋臼骨折的手术治疗 |
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Received:January 25, 2010
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| 作者 | Author | 单位 | Unit | E-Mail |
| 景灵勇 |
JING Ling-yong |
宁波市第六医院骨科,浙江 宁波 315040 |
Department of Orthopaedics,the Sixth Hospital of Ningbo City,Ningbo 315040,Zhejiang,China |
allyssess@163.com |
| 刘观燚 |
LIU Guan-yi |
宁波市第六医院骨科,浙江 宁波 315040 |
Department of Orthopaedics,the Sixth Hospital of Ningbo City,Ningbo 315040,Zhejiang,China |
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| 胡勇 |
HU Yong |
宁波市第六医院骨科,浙江 宁波 315040 |
Department of Orthopaedics,the Sixth Hospital of Ningbo City,Ningbo 315040,Zhejiang,China |
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| 张飞 |
ZHANG Fei |
宁波市第六医院骨科,浙江 宁波 315040 |
Department of Orthopaedics,the Sixth Hospital of Ningbo City,Ningbo 315040,Zhejiang,China |
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| 阮永平 |
RUAN Yong-ping |
宁波市第六医院骨科,浙江 宁波 315040 |
Department of Orthopaedics,the Sixth Hospital of Ningbo City,Ningbo 315040,Zhejiang,China |
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| 徐荣明 |
XU Rong-ming |
宁波市第六医院骨科,浙江 宁波 315040 |
Department of Orthopaedics,the Sixth Hospital of Ningbo City,Ningbo 315040,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年23卷，第5期，第386-388页 |
| DOI：10.3969/j.issn.1003-0034.2010.05.022 |
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目的：探讨陈旧性髋臼骨折手术治疗的方法及疗效评价。
方法：2001年10月至2007年10月手术治疗陈旧性髋臼骨折26例，其中男21例，女5例；年龄18～65岁，平均35.6岁。按Letourne-Judet分型，后壁9例，横形3例，横形加后壁7例，后柱加后壁2例，T形2例，双柱3例。术前经骨盆CT三维重建明确诊断分型后，均采用手术治疗；伤后23～141 d手术，平均36.4 d.分别采用前、后入路，前后联合入路显露并复位，AO重建钢板内固定。
结果：26例获得随访，时间6个月～8年，平均32.4个月。26例患者Matta评分：疼痛(5.04±1.04)分，活动度(5.23±0.76)分，行走情况(4.92±1.16)分，总分(5.06±0.99)分；其中，优6例，良10例，中6例，差4例。术后出现的外侧皮神经损伤3例，坐骨神经损伤2例，股骨头坏死1例，感染1例，异位骨化6例。
结论：对陈旧性髋臼骨折的治疗要准确地进行术后评估，严格掌握手术指征，选择恰当的手术入路，正确的复位固定方法，可以获得相对满意的治疗效果。 |
| [关键词]:髋臼 骨折 外科手术 |
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| Operative treatment of old acetabular fractures |
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Abstract:
Objective: To explore the operative methods and effects of treatment of old acetabular fractures.
Methods: From October 2001 to October 2007,26 patients with old acetabular fractures were treated with operation including 21 males and 5 females with an average age of 34 years ranging from 18 to 65 years. On the basis of the three-dimensional computed tomography,all cases were diagnosed and classified according to Letourne-Judet classification,9 cases were posterior wall fracture,3 cases were lateropulsition fracture,7 cases were lateropulsition and posterior wall fracture,2 cases were posterior column and posterior wall fracture,2 were T-shape fracture,3 were dual column fracture. These patients were treated through the anterior,posterior, combined anterior-posterior approaches. The time from injured to operation was 33 to 141 days(averaged 36.4 days). All the fractures were fixed with screws and AO reconstruction plates.
Results: All patients were followed up for 6 to 96 months,with an average time of 32.4 months. Evaluated according to Matta criteria,the results of scores was(5.04±1.04) on pain,(5.23±0.76)on range of motion,(4.92±1.16)on walking,and tatal(5.06±0.99)on average;The functional results of hip joints were excellent in 6 cases,good in 10 cases,fair in 6 cases,and poor in 4 cases. Sciatic nerve injury was found in 2 patients,lateral femoral cutaneus nerve injury in 3 patients,necrosis of femoral head in 1 patient,infection in 1 patient,and ectopic bone formation in 6 patients.
Conclusion: Good clinical results can be obtained by careful selection of operative indications of old acetabular fractures in combination with proper operative approach and correct reduction and fixation. |
| KEYWORDS:Acetabulum Fractures Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 景灵勇,刘观燚,胡勇,张飞,阮永平,徐荣明.陈旧性髋臼骨折的手术治疗[J].中国骨伤,2010,23(5):386~388 |
| 英文格式: | JING Ling-yong,LIU Guan-yi,HU Yong,ZHANG Fei,RUAN Yong-ping,XU Rong-ming.Operative treatment of old acetabular fractures[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(5):386~388 |
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