Operative Treatment of Complex Acetabular Fractures_West China Medical Journal

Authors：

1.Department of Orthopedics, The Fifth People’s Hospital of Chengdu City, Chengdu 611130; 2.Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China;

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Keywords：

髖臼骨折; 分型; 手術入路; 骨折固定術

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目的:探討復雜髖臼骨折的手術治療方法及與療效。方法:總結2002年2月～2007年12月對20例復雜髖臼骨折手術治療的經驗。其中男性14例,女性6例;年齡18～58歲,平均41歲。術前根據X線片及CT檢查結果,所有骨折均按Letournel-Judet的方法進行分型、復合型20例。根據不同骨折類型,分別采用Kocher-Langenbeck入路10例,髂腹股溝入路4例及前后聯合入路6例進行復位、固定。平均手術耗時3.5 h,術中平均失血900 mL。〖HTH〗結果〖HTSS〗:所有患者術后隨訪時間12～48個月,平均30個月。根據Matta影像學評分,解剖復位12例,復位滿意4例,復位不滿意4例。根據美國矯形外科學會髖關節功能評價標準,關節功能優6例,良8例,差6例,優良率為70%。解剖復位加滿意復位的臨床優良率為78.5%,而滿意復位和差的復位的優良率為25%(P lt;0.05)。結論:不同的髖臼骨折需采用不同開放復位策略,其選擇決定于髖臼骨折的類型,移位方向及其相應的手術入路。解剖復位、牢固固定、早期功能鍛煉是提高療效的關鍵。

Citation： GU Qishan,BAN Zhaolan,PENG Xiao,et al. Operative Treatment of Complex Acetabular Fractures. West China Medical Journal, 2009, 24(4): 840-842. doi: Copy

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2.	SIEBENROCK K A, GAUTIER E, ZIRAN BH, et al. Trochanteric flip osteotomy for cranial extension and muscle protection in acetabular fracture fixation using a Kocher-Langenbeck approach [J]. J Orthop Trauma,2006,20(1 Suppl):52-56..
3.	PETSATODIS G, ANTONARAKOS P, CHALIDIS B, et al. Surgically treated acetabular fractures via a single posterior approach with a follow-up of 2-10years[J]. Injury,2007,38(3):334-343.
4.	李連欣,周東生,張連祿,等.手術治療髖臼雙柱骨折(附21例報告)[J].中國矯形外科雜志,2004,12(14):1045-1048..
5.	楊國敬,張力威,王偉良,等.移位髖臼骨折的內固定治療[J].實用骨科雜志,2003,9(5):412-413..
6.	周東生,王先泉,王伯珉,等.前后聯合入路治療復雜髖臼骨折(附46例報告)[J].中國矯形外科雜志,2004,12:170-172..
7.	STOCKLE U, HOFFMANN R, SUDKAMP N P, et al. Treatment of complex acetabular fractures through a modified extended iliofemoral approach[J]. Orthop Trauma,2002,16(4):220-230..
8.	蔡賢華,陳莊洪,徐永年,等.不同髖臼骨折手術入路選擇的相關性因素分析[J].中國矯形外科雜志,2006.14(20):1526-1528..
9.	GLAS P Y, FESSY M H, CARRET J P, et al. Surgical treatment of acetabular fractures: outcome in a series of 60 consecutive cases [J]. Rev Chir Orthop Reparatrice Appar Mot,2001,87:529-538..
10.	吳新寶,王滿宜,朱仕文,等.12例髖臼骨折手術治療結果分析[J].中華創傷雜志,2002,18:80-84..

1. TORNETTA P 3RD, REILLY M, MATTA J. Acetabular fracture/dislocation[J]. Orthop Trauma,2002,16:139-142..
2. SIEBENROCK K A, GAUTIER E, ZIRAN BH, et al. Trochanteric flip osteotomy for cranial extension and muscle protection in acetabular fracture fixation using a Kocher-Langenbeck approach [J]. J Orthop Trauma,2006,20(1 Suppl):52-56..
3. PETSATODIS G, ANTONARAKOS P, CHALIDIS B, et al. Surgically treated acetabular fractures via a single posterior approach with a follow-up of 2-10years[J]. Injury,2007,38(3):334-343.
4. 李連欣,周東生,張連祿,等.手術治療髖臼雙柱骨折(附21例報告)[J].中國矯形外科雜志,2004,12(14):1045-1048..
5. 楊國敬,張力威,王偉良,等.移位髖臼骨折的內固定治療[J].實用骨科雜志,2003,9(5):412-413..
6. 周東生,王先泉,王伯珉,等.前后聯合入路治療復雜髖臼骨折(附46例報告)[J].中國矯形外科雜志,2004,12:170-172..
7. STOCKLE U, HOFFMANN R, SUDKAMP N P, et al. Treatment of complex acetabular fractures through a modified extended iliofemoral approach[J]. Orthop Trauma,2002,16(4):220-230..
8. 蔡賢華,陳莊洪,徐永年,等.不同髖臼骨折手術入路選擇的相關性因素分析[J].中國矯形外科雜志,2006.14(20):1526-1528..
9. GLAS P Y, FESSY M H, CARRET J P, et al. Surgical treatment of acetabular fractures: outcome in a series of 60 consecutive cases [J]. Rev Chir Orthop Reparatrice Appar Mot,2001,87:529-538..
10. 吳新寶,王滿宜,朱仕文,等.12例髖臼骨折手術治療結果分析[J].中華創傷雜志,2002,18:80-84..

West China Medical Journal

Operative Treatment of Complex Acetabular Fractures

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