| 赵科平,陈国兆,王黎明,等.相对微创有限切开髂腹股沟入路重建钢板内固定治疗髋臼骨折的临床疗效分析.骨科,2019,10(6): 515-520. |
| 相对微创有限切开髂腹股沟入路重建钢板内固定治疗髋臼骨折的临床疗效分析 |
| Treatment of acetabular fractures with reconstructive plate internal fixation through relatively minimally invasive ilio-inguinal approach with limited incision |
| 投稿时间：2019-04-08 |
| DOI：10.3969/j.issn.1674-8573.2019.06.006 |
| 中文关键词: 髂腹股沟入路 钢板内固定 髋臼骨折 短期疗效 |
| 英文关键词: Ilio-inguinal approach Plate internal fixation Acetabular fracture Short-term effect |
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| 中文摘要: |
| 目的 探讨相对微创有限切开髂腹股沟入路重建钢板内固定治疗髋臼骨折的临床疗效。方法 回顾性分析2013年3月至2017年3月在我院采用相对微创有限切开髂腹股沟入路重建钢板内固定治疗的15例髋臼骨折病人，其中男9例，女6例，年龄为（44.13±8.64）岁（28~58岁），左侧6例，右侧9例，高处坠落伤7例，车祸伤8例。按Letournel分型，双柱骨折6例，前柱骨折2例，T形骨折4例，横行骨折3例，骨折移位均超过3 mm。术后采用Matta、Merle d'Aubigne和Postel标准评价髋关节功能。结果 病人手术时间为（2.70±0.49） h（2.0~3.5 h），术中出血量为（413.33±130.20） ml（200~600 ml）；骨折均愈合，愈合时间为（16.93±2.66）周（14~24周）。所有病人均获得随访，随访时间为（14.00±2.95）个月（9~20个月）。依据Matta评定标准，优8例，良5例，差2例，优良率为86.67%。按Merle d'Aubigne和Postel的标准评价髋关节功能，优7例，良6例，可2例，优良率为86.67%。异位骨化Ⅰ度1例。1例发生创伤性关节炎，予保守治疗。短期随访无股外侧皮神经损伤、股骨头缺血性坏死、切口感染及骨折不愈合等并发症发生。结论 相对微创有限切开髂腹股沟入路重建钢板内固定治疗髋臼骨折复位效果良好、并发症发生率较低，短期疗效满意。 |
| 英文摘要: |
| Objective To explore the clinical effect of acetabular fracture treated with reconstructive plate and internal fixation through relatively minimally invasive limited incision of ilio-inguinal approach. Methods From March 2013 to March 2017, 15 patients with acetabulum fracture treated by reconstructive plate internal fixation through relatively minimally invasive ilio-inguinal approach with limited incision were analyzed retrospectively. Among them, there were 6 cases on the left side, 9 cases on the right side, 7 cases of falling injury and 8 cases of traffic accident injury. According to Letournel classification, there were 6 cases of double column fracture, 2 cases of anterior column fracture, 4 cases of T shaped fracture, 3 cases of transverse fracture. The displacement was more than 3 mm. Matta, Merle d'Aubigne and Postel criteria were used to evaluate hip function after operation. Results The operative time of the patients was (2.70±0.49) h (2.0-3.5 h) and the intraoperative bleeding volume was (413.33±130.20) ml (200-600 ml). All the fractures healed and the healing time was (16.93±2.66) weeks (14-24 weeks). All patients were followed up for (14.00±2.95) months (9-20 months). According to Matta score system, 8 cases were excellent, 5 were good and 2 were poor, and the excellent and good rate was 86.67%. According to Merle d'Aubigne and Postel score system, 7 were excellent, 6 were good and 2 were fair, and the excellent and good rate was 86.67%. One case had heterotopic ossification. One case of traumatic arthritis was treated conservatively. No complications such as injury of lateral femoral cutaneous nerve, avascular necrosis of femoral head, infection of incision and nonunion of fracture occurred during short-term follow-up. Conclusion Reconstructive plate and internal fixation through relatively minimally invasive limited incision of ilio-inguinal approach has good effect on the treatment of acetabular fracture, with low incidence of complications and satisfactory short-term effect. |
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