摘要
目的 探讨髂后侧经臀小肌微创入路治疗髋臼后侧骨折的方法.方法 使用髂后侧经臀小肌微创入路修复髋臼后侧骨折21例,其中单纯后壁骨折9例,后柱＋后壁骨折7例,横行＋后壁骨折4例,单纯横行骨折1例.分析新型手术入路的切口长度、手术时间、出血量及术后并发症.术后平均随访6-17个月,手术效果经术后X线及改良的Merle d,Aubigne和Postel的髋臼骨折临床结果评分.结果 本组21例手术切口长度8-11 cm,平均9.4 cm;手术用时1.5-4.5 h,平均2.2 h;术中失血量300-900 ml,平均430 ml.全部病例无坐骨神经损伤、切口感染、深静脉血栓、创伤性关节炎等并发症.17例获得解剖复位,3例良好复位,1例复位差.术后远期复查结果,依据Merle d,Aubigne和Postel髋关节评分系统,优10例,良8例,一般2例,差1例,优良率为85.7%.结论 髂后经臀小肌微创入路损伤小,安全,显露好,是修复髋臼后侧骨折的入路的良好选择之一.
Objective To explore a new method for repairing acetabular posterior fracture by minimally invasive posterior approach through gluteus minimush. Methods 21 patients with acetabular posterior fracture were repaired by minimally invasive posterior approach, including 9 cases with simple posterior wall fractures,7 cases with posterior column and posterior wall fractures,4 cases with transverse and posterior wall fractures, 1 case with simple transverse fracture. Incision length ,duration of operation, amount of bleeding and postoperative complications of the new surgical approach were analyzed with 6 - 17 months follow - up after surgery. Operation effects were evaluated by postoperative X - ray and modified Merle d＇ Aubigne and Postel acetabular fracture clinical outcome scores. Results Incision length was 8 - 11 cm with average length 9.4 cm, duration of operation was 1.5 - 4.5 h with average duration 2.2 h, amount of bleeding was 300 - 900 ml with average amount 430 ml. No sciatic nerve injury, incision infection, deep vein thrombosis,traumatic arthritis and other complications occurred. 17 cases achieved anatomical reduction, 3 cases a- chieved good reduction, 1 cases achieved poor reduction. According to Merle d＇ Aubigne and Postel acetabular fracture clinical outcome scores system, 10 cases were excellent,8 cases were good,2 cases were general and 1 case was poor. The excellent and good rate was 85.7%. Conclusion Minimally invasive posterior approach through gluteus mini- mush is safe with good exposure,which is a good choice to repair acetabular posterior fracture.
出处
《医学新知》
CAS
2017年第1期36-39,F0004,共5页
New Medicine
关键词
髋臼后壁骨折
臀小肌
微创入路
髋关节功能
Acetabular posterior fracture
Gluteus minimus
Minimally invasive approach
Hip joint function
