| 股骨大转子截骨联合Kocher-Langenbeck入路治疗髋臼高位后壁骨折 |
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Received:March 12, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王晓盼 |
WANG Xiao-pan |
蚌埠医科大学第一附属医院创伤骨科 组织移植安徽省重点实验室, 安徽 蚌埠 233004 |
Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Provincial Key Laboratory of Tissue Transplantation, Bengbu 233004, Anhui, China |
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| 陈笑天 |
CHEN Xiao-tian |
蚌埠医科大学第一附属医院创伤骨科 组织移植安徽省重点实验室, 安徽 蚌埠 233004 |
Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Provincial Key Laboratory of Tissue Transplantation, Bengbu 233004, Anhui, China |
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| 李仁杰 |
LI Ren-jie |
蚌埠医科大学第一附属医院创伤骨科 组织移植安徽省重点实验室, 安徽 蚌埠 233004 |
Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Provincial Key Laboratory of Tissue Transplantation, Bengbu 233004, Anhui, China |
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| 刘乐予 |
LIU Le-yu |
蚌埠医科大学第一附属医院创伤骨科 组织移植安徽省重点实验室, 安徽 蚌埠 233004 |
Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Provincial Key Laboratory of Tissue Transplantation, Bengbu 233004, Anhui, China |
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| 代秀松 |
DAI Xiu-song |
蚌埠医科大学第一附属医院创伤骨科 组织移植安徽省重点实验室, 安徽 蚌埠 233004 |
Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Provincial Key Laboratory of Tissue Transplantation, Bengbu 233004, Anhui, China |
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| 官建中 |
GUAN Jian-zhong |
蚌埠医科大学第一附属医院创伤骨科 组织移植安徽省重点实验室, 安徽 蚌埠 233004 |
Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Provincial Key Laboratory of Tissue Transplantation, Bengbu 233004, Anhui, China |
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| 吴敏 |
WU Min |
蚌埠医科大学第一附属医院创伤骨科 组织移植安徽省重点实验室, 安徽 蚌埠 233004 |
Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Provincial Key Laboratory of Tissue Transplantation, Bengbu 233004, Anhui, China |
635741385@qq.com |
| 陈晓东 |
CHEN Xiao-dong |
蚌埠医科大学第一附属医院创伤骨科 组织移植安徽省重点实验室, 安徽 蚌埠 233004 |
Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Provincial Key Laboratory of Tissue Transplantation, Bengbu 233004, Anhui, China |
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| 期刊信息：《中国骨伤》2024年37卷，第7期，第706-712页 |
| DOI：10.12200/j.issn.1003-0034.20230928 |
| 基金项目:安徽省卫生健康科研项目(编号:AHWJ2023A10086);安徽高校自然科学研究项目(编号:KJ2021A0771);蚌埠医学院自然科学基金重点项目(编号:2020byzd111) |
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目的：评价股骨大转子截骨技术联合 Kocher-Langenbeck 入路治疗髋臼高位后壁骨折的临床疗效。
方法：回顾分析 2020 年 1 月至 2022 年 12 月收治的髋臼高位后壁骨折患者 20 例,其中男 12 例,女 8 例;年龄 18~75 岁。根据手术方式的不同分为两组,10 例采用股骨大转子截骨联合 Kocher-Langenbeck 入路为观察组,男 5 例,女 5 例,年龄 18~75 岁;10 例单纯 Kocher-Langenbeck 入路为对照组,男 7 例,女 3 例,年龄 18~71 岁。使用 Matta 复位标准评价两组骨折的复位质量,末次随访时采用 Harris 评分比较两组患者髋关节功能。分析两组患者手术时间、失血量、术后并发症情况。
结果：两组患者均获得随访,时间 10~24 个月。根据 Matta 骨折复位质量评价标准,观察组获解剖复位 6 例,满意复位 3 例,不满意复位 1 例;而对照组仅 3 例获解剖复位,满意复位 3 例,不满意复位 4 例。末次随访时,观察组髋关节 Harris 评分为 71.4~96.6 分,对照组为 65.3~94.5 分。根据 Harris 评分结果,观察组髋关节功能优 6 例,良 3 例,可1 例;对照组,优 2 例,良 3 例,可 3 例,差 2 例。观察组术中出血量 300~700 ml,手术时间 120~180 min;对照组术中出血量 300~650 ml,手术时间 100~180 min。观察组创伤性关节炎 1 例,异位骨化 1 例;对照组创伤性关节炎 3 例,异位骨化 3 例,髋外展无力 1 例。
结论：通过对结果数据的分析,与单纯采用 Kocher-Langenbeck 入路相比,将股骨大转子截骨技术用于高位后壁骨折的治疗,能够有效提高骨折解剖复位率,提升髋关节功能优良率,同时降低手术并发症的发生,值得临床应用。但因样本量较少,未进行相关统计学分析,结论仍需要进一步的临床验证。 |
| [关键词]:髋臼骨折 高位后壁骨折 大转子截骨 Kocher-Langenbeck入路 |
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| Analysis of the therapeutic effect of trochanteric flip osteotomy combined with Kocher-Langenbeck approach for high acetabular posterior wall fracture |
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Abstract:
Objective Evaluation of the clinical efficacy of f trochanteric flip osteotomy combined with Kocher-Langenbeck approach for high acetabular posterior wall fracture.
Methods Between January 2020 and December 2022,20 patients with high acetabular posterior wall fractures were retrospectively analyzed,including 12 males and 8 females,aged 18 to 75 years old. They were divided into two groups according to the different surgical methods. Ten patients were treated with greater trochanteric osteotomy combined with Kocher-Langenbeck approach as the observation group,including 5 males and 5 females,aged from 18 to 75 years old. Ten patients were treated with Kocher-Langenbeck approach alone as the control group, including 7 males and 3 females,aged from 18 to 71 years old. Matta reduction criteria were used to evaluate the reduction quality of the two groups,and Harris score was used to compare the hip function of the two groups at the latest follow-up. The operation time,blood loss and postoperative complications of the two groups were analyzed.
Results All patients were followed up for 10 to 24 months. According to the Matta fracture reduction quality evaluation criteria,the observation group achieved anatomical reduction in 6 cases,satisfactory reduction in 3 cases,and unsatisfactory reduction in 1 case,while the control group only achieved anatomical reduction in 3 cases,satisfactory reduction in 3 cases,and unsatisfactory reduction in 4 cases. At the final follow-up,the Harris hip score ranged from 71.4 to 96.6 in the observation group and 65.3 to 94.5 in the control group. According to the results of Harris score. The hip joint function of the observation group was excellent in 6 cases,good in 3 cases,and fair in 1 case. The hip joint function of the control group was excellent in 2 cases,good in 3 cases,fair in 3 cases, and poor in 2 cases. In the observation group,the intraoperative blood loss ranged from 300 to 700 ml,and the operation duration ranged from 120 to 180 min;in the control group,the intraoperative blood loss ranged from 300 to 650 ml,and the operation duration ranged from 100 to 180 min. Complications in the observation group included 1 case of traumatic arthritis and 1 case of heterotopic ossification,while complications in the control group included 3 cases of traumatic arthritis,3 cases of heterotopic ossification and 1 case of hip abduction weakness.
Conclusions Trochanteric flip osteotomy combined with the Kocher -Langenbeck approach significantly improved anatomical fracture reduction rates,enhanced excellent and good hip joint function outcomes,and reduced surgical complication incidence compared to the Kocher-Langenbeck approach alone. Clinical application of this combined approach is promising,although larger studies are needed for further validation. |
| KEYWORDS:Acetabular fracture High posterior wall fracture Trochanteric flip osteotomy Kocher -Langenbeck approach |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王晓盼,陈笑天,李仁杰,刘乐予,代秀松,官建中,吴敏,陈晓东.股骨大转子截骨联合Kocher-Langenbeck入路治疗髋臼高位后壁骨折[J].中国骨伤,2024,37(7):706~712 |
| 英文格式: | WANG Xiao-pan,CHEN Xiao-tian,LI Ren-jie,LIU Le-yu,DAI Xiu-song,GUAN Jian-zhong,WU Min,CHEN Xiao-dong.Analysis of the therapeutic effect of trochanteric flip osteotomy combined with Kocher-Langenbeck approach for high acetabular posterior wall fracture[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(7):706~712 |
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