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后上后前序贯复位固定C1型髋臼骨折的手术治疗
Hits: 2027   Download times: 1382   Received:November 25, 2012    
作者Author单位UnitE-Mail
兰树华 LAN Shu-hua 丽水市中心医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the Central Hospital of Lishui, Lishui 323000, Zhejiang, China lsh2681225@163.com 
朱俊锟 ZHU Jun-kun 丽水市中心医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the Central Hospital of Lishui, Lishui 323000, Zhejiang, China  
黄淑明 HUANG Shu-ming 丽水市中心医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the Central Hospital of Lishui, Lishui 323000, Zhejiang, China  
叶积飞 YE Ji-fei 丽水市中心医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the Central Hospital of Lishui, Lishui 323000, Zhejiang, China  
吴泉州 WU Quan-zhou 丽水市中心医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the Central Hospital of Lishui, Lishui 323000, Zhejiang, China  
叶方 YE Fang 丽水市中心医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the Central Hospital of Lishui, Lishui 323000, Zhejiang, China  
吕国强 LÜ Guo-qiang 丽水市中心医院骨科, 浙江 丽水 323000 Department of Orthopaedics, the Central Hospital of Lishui, Lishui 323000, Zhejiang, China  
期刊信息:《中国骨伤》2013年26卷,第6期,第516-520页
DOI:10.3969/j.issn.1003-0034.2013.06.019


目的: 探讨C1型AO/ASIF分型髋臼骨折的手术复位技巧,分析其临床疗效。

方法: 自2004年8月至2012年1月,采用前后联合入路进行后上后前序贯复位、内固定治疗C1型AO/ASIF分型髋臼骨折13例,其中男8 例,女5例;年龄18~64岁,平均42岁。术前经骨盆三维重建CT明确诊断分型后,于伤后5~20 d手术,平均9.5 d.观察手术时间、术中出血量、术后并发症情况并评价手术复位质量,末次随访时采用Matta复位标准对患者的髋关节功能进行评估。

结果: 手术时间为190~290 min,平均240 min;术中出血量1 300~3 000 ml,平均1 800 ml.术后1例出现浅表感染,经加强换药于3周后愈合。根据Matta复位标准:解剖复位8例,满意复位4例,不满意复位1例。术后11例患者获得随访,平均随访时间(24.0±8.0)个月,骨折均愈合。末次随访时根据改良Meded'Aubingne和Postel临床评分:优7例,良2例,可1例,差1例。

结论: 对C1型AO/ASIF分型的髋臼骨折,采用后上后前的顺序进行序贯复位技术,手术流程满意,对提高手术质量有一定的帮助。
[关键词]:髋臼  骨折  外科手术  骨折固定术,内
 
Surgical treatment of acetabular type C1 acetabular fracture by posteroproximal-posteroanterior sequential reduction and internal fixation
Abstract:

Objective: To investigate the operative reduction techniques and clinical results of surgical treatment of type C1(AO/ASIF) acetabular fracture by posteroproximal-posteroanterior sequential reduction and internal fixation.

Methods: From August 2004 to January 2012,13 patients with type C1(AO/ASIF) acetabular fracture were treated by posteroproximal-posteroanterior sequential reduction and internal fixation. Of them,8 cases were male and 5 cases were female with an average age of 42 years years old (ranged,18 to 64). Pelvis 3-dimentional CT reconstruction were used to confirmed the classification of fracture,and the operation were performed during from 5 to 20 days with an average of 9.5 days. Operation time,blood loss,complications and reduction were recorded and evaluated. The function of hip joint were accessed at the final follow-up.

Results: The operation time ranged from 190 to 290 min with an average of 240 min. The mean blood loss was 1 800 ml (ranged,1 300 to 3 000 ml). One case had superficial infection and healed after 3 weeks. According to Matta reduction criteria,8 cases obtained anatomical reduction,4 cases got satisfied results and 1 cases got unsatisfied results. Eleven cases were followed up with an average of (24.0±8.0) months,and 2 cases were lost to follow-up. According to revised Mede d'Aubingne and Postel evaluation system,7 cases got excellent results,2 good,1 moderate and 1 poor.

Conclusion: Posteroproximal-posteroanterior sequential reduction and internal fixation for the treatment of type C1(AO/ASIF) acetabular fracture can achieve satisfied surgical proces and operation quality.
KEYWORDS:Acetabulum  Fractures  Surgical procedures,operative  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:兰树华,朱俊锟,黄淑明,叶积飞,吴泉州,叶方,吕国强.后上后前序贯复位固定C1型髋臼骨折的手术治疗[J].中国骨伤,2013,26(6):516~520
英文格式:LAN Shu-hua,ZHU Jun-kun,HUANG Shu-ming,YE Ji-fei,WU Quan-zhou,YE Fang,LÜ Guo-qiang.Surgical treatment of acetabular type C1 acetabular fracture by posteroproximal-posteroanterior sequential reduction and internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(6):516~520
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