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改良Stoppa入路在治疗骨盆髋臼骨折中的应用
Hits: 2642   Download times: 1104   Received:August 15, 2012    
作者Author单位UnitE-Mail
樊良 FAN Liang 绍兴市人民医院,浙江 绍兴 312000 Peoples' Hospital of Shaoxing in Zhejiang Province,Shaoxing 312000,Zhejiang,China god-fan@hotmail.com 
金以军 JIN Yi-jun 绍兴市人民医院,浙江 绍兴 312000 Peoples' Hospital of Shaoxing in Zhejiang Province,Shaoxing 312000,Zhejiang,China  
何磊 HE Lei 绍兴市人民医院,浙江 绍兴 312000 Peoples' Hospital of Shaoxing in Zhejiang Province,Shaoxing 312000,Zhejiang,China  
吕佐 LÜ Zuo 绍兴市人民医院,浙江 绍兴 312000 Peoples' Hospital of Shaoxing in Zhejiang Province,Shaoxing 312000,Zhejiang,China  
范宏辉 FAN Hong-hui 绍兴市人民医院,浙江 绍兴 312000 Peoples' Hospital of Shaoxing in Zhejiang Province,Shaoxing 312000,Zhejiang,China  
期刊信息:《中国骨伤》2012年25卷,第10期,第810-812页
DOI:10.3969/j.issn.1003-0034.2012.10.006


目的:探讨改良Stoppa入路在骨盆髋臼骨折治疗中的应用疗效.

方法:2010年3月至2012年5月共收治16例骨盆骨折和7例髋臼骨折患者,男18例,女5例;年龄17~65岁,平均39岁.16例骨盆骨折按Tile分型:B1型1例,B2型2例,B3型3例;C1-1型4例,C1-2型2例,Cl-3型2例,C2型2例.7例髋臼骨折按Letournel分型:前柱骨折l例,横形骨折1例,T形骨折2例,前柱伴后半横形骨折1例,双柱骨折2例.16例骨盆骨折中单独使用改良Stoppa入路9例,联合髂窝入路6例,联合后路l例.7例髋臼骨折中单独使用改良Stoppa入路4例,联合Kocher-Langenbeck入路2例,联合髂窝入路及Kocher-Langenbeck入路1例.

结果:23例患者手术时间50~350 min,平均130 min;出血量100~1200 ml,平均320 ml;无手术并发症.术后根据Matta影像学评分,16例骨盆骨折均复位优;髋臼骨折复位优4例,良3例.21例患者获得随访,时间4~24个月,平均8个月,骨折均获愈合,愈合时间2.5~5个月,平均3.2个月.螺钉松动1例,l例屈髋轻度受限,无钢板断裂,无腹壁疝情况.

结论:改良Stoppa入路治疗骨盆、髋臼骨折,其操作安全简捷、并发症少的优点,具有一定的应用价值.
[关键词]:骨盆  髋臼  骨折  外科手术
 
Modified Stoppa approach in treatment of pelvic and acetabular fractures
Abstract:

Objective:To evaluate the modified Stoppa approach in treatment of pelvic and acetabular fractures.

Methods:From March 2010 to May 2012,16 patients with pelvic fractures and 7 patients with acetabutar fractures were treated by open reduction and internal fixation through the modified Stoppa approach,involving 18 males and 5 females with an average age of 39 years ranging from 17 to 65. By Tile classification,16 cases of pelvic fractures included 1 case of B1,2 of B2,3 of B3,4 of C1-1,2 of C1-2,2 of C1-3,and 1 of C2. By Letournel classification,7 cases of acetabular fractures included 1 case of anterior column fractures,1 of transverse fractures,2 of type T,1 of anterior column plus posterior transverse fractures,and 2 cases of both columns fractures. For 16 pelvic fractures,the modified Stoppa approach was used exclusively in 9 cases,in combination with the iliac fossa approach in 6 cases,and in combination with the posterior approach in 1 case. For 7 acetabular fractures,the modified Stoppa approach was used exclusively in 4 cases,in combination with the Kocher-Langenbeck approach in 2 cases,and in combination with the Kocher-Langenbeck and iliac fossa approaches in 1 case of both columns fractures.

Results:The average operation time was 130 min (50 to 350 min) and the blood loss averaged 320 ml (100 to 1200 ml). There were no operative complications. The reductions of the pelvic and acetabular fractures were all excellent and good. Twenty-one patients were followed-up from 4 to 24 months (averaged 8 months). The fractures were all healed,the fracture healing time was 2.5 to 5 months (means 3.2 months). Among them,1 case occurrenced screw loosening,1 case had mild limited of hip flexion,no case had plate breakage and lateral ventral syndrome.

Conclusion:The modified Stoppa approach can be used to treat pelvic and acetabular fractures effectively,and it has advantages of easy manipulation and a low complication rate.
KEYWORDS:Pelvis  Acetabulum  Fractures  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:樊良,金以军,何磊,吕佐,范宏辉.改良Stoppa入路在治疗骨盆髋臼骨折中的应用[J].中国骨伤,2012,25(10):810~812
英文格式:FAN Liang,JIN Yi-jun,HE Lei,LÜ Zuo,FAN Hong-hui.Modified Stoppa approach in treatment of pelvic and acetabular fractures[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(10):810~812
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