摘要
目的：比较治疗髋臼骨折的髂腹股沟下入路和髂腹股沟入路的解剖学差别,并探讨髂腹股沟下入路的临床疗效.方法：选取男女新鲜尸体标本7具,同一标本做左右两侧对比研究,左侧采用髂腹股沟入路,右侧采用髂腹股沟下入路,切口内侧均自耻骨联合上方2 cm开始横行,切口外侧沿髂骨嵴至髂前上棘后外5 cm处,对比测量切口第1窗暴露的长径、横径和髂腰肌游离度.并随访观察2010年5月至2012年8月采用单一髂腹股沟下入路治疗的15例髋臼骨折患者的手术疗效,其中男12例,女3例;年龄20～65岁,平均40.6岁,采用Matta标准进行疗效评价.结果：髂腹股沟下入路在切口第1窗暴露长径、横径和髂腰肌游离度均优于髂腹股沟入路（P＜0.01）.临床观察15例髋臼骨折患者,根据Mata复位标准,10例获得解剖复位,5例复位满意;所有患者X线片结果为优.结论：相比经典的髂腹股沟入路,髂腹股沟下入路可显著扩大第1窗口的暴露范围,同时手术步骤简单.此入路是暴露髋臼前柱、前内侧壁和髋关节前方的理想手术入路.
Objective：To compare anatomical differences between subinguinal and ilioinguinal approaches for the treatment of acetabular fracture and investigate clinical therapeutic effect of subinguinal approach.Methods：Seven fresh human bodies were chosen,comparative study were performed on the right and left side on the same specimen.Ilioinguinal approaches were adopted on the left and subinguinal were adopted on the right.Inner part of incision started to sun wild above pubic symphysis at 2 cm,and lateral incision ranged from iliac to anterior superior spine about 5 cm.Length and transverse diameter of the first window exposed and lliopsoas freeness were tested and compared.Fifteen acetabular fracture patients treated through subinguinal approach were compared from May 2010 to August 2012.Among all patients,including 12 males and 3 females aged from 20 to 65 years old with an average of 40.6 years old.Matta criteria were used to evaluate clinical outcomes.Results：Length and transverse diameter of the first window exposed and lliopsoas freeness through subinguinal approach were better than through ilioinguinal approach （P＜0.01）.In 15 patients with acetabular fracture,10 patients obtained anatomical reduction and 10 patients got satisfied reduction in accordance with Matta criteria.X-ray results of all patients were excellent.Conclusion：Compared with ilioinguinal approach,subinguinal approach could enlarge visualization of the first window and simplify surgical procedure.It is an ideal approach to expose anterior and anterior-medialis wall of acetabulum and anterior hip capsule.
出处
《中国骨伤》
CAS
2014年第12期1019-1023,共5页
China Journal of Orthopaedics and Traumatology
关键词
腹股沟
髋臼
骨折
解剖学
比较
Groin
Acetabulum
Fractures
Anatomy,comparative
