摘要
目的探讨采用改良Stoppa入路联合髂窝入路顺行髂坐螺钉治疗累及后柱的复杂髋臼骨折的临床疗效。方法回顾性分析2014年1月至2017年12月收治的30例复杂髋臼骨折患者的临床资料。根据手术方式不同将患者分为研究组与对照组。研究组采用改良Stoppa入路联合髂窝入路,分别于髂耻柱铺设钢板稳定前柱及骨盆内侧植入髂坐螺钉固定后柱骨折。对照组采用前方改良Stoppa入路联合后方Kocher-Langenbeck入路,分别于髂耻柱铺设钢板稳定前柱及后方重建钢板固定后柱骨折。比较两组患者的临床疗效。结果研究组手术时间及术中出血量均明显少于对照组,差异均有统计学意义(P<0.05)。按改良Matta标准评定术后骨折复位质量,研究组优良率为93.33%,对照组优良率为86.67%;按改良的Merled?Aubigné和Postel功能评分系统评定术后1年随访时患髋功能,研究组优良率为93.33%;对照组优良率为80.00%。以上两个项目患者优良率比较,差异均无统计学意义。术后并发症发生率比较,差异无统计学意义(P>0.05)。结论对于累及后柱的复杂髋臼骨折,改良Stoppa入路联合髂窝入路顺行髂坐螺钉具有手术时间短、术中出血量少、固定牢靠、损伤小等优点,是一种理想的手术方式。
Objective To investigate the effectiveness of antegradeilioischial screws through modified Stoppa and iliac fossa approaches for complex acetabular fractures involving the posterior column.Methods A consecutive series of 30 patients with complex acetabular fracture were treated operatively from January 2014 to December 2017.Of them,15 were treated through modified Stoppa plus iliac fossa approaches as the research group.The anterior column was stabilized with a reconstruction plate for the iliac wing along the iliopectineal line to the pubis in all cases.The posterior column was fixed with antegradeilioischial screws.The other 15 patients served as the control group, treated with a reconstruction plate for the conventional posterior column fixation through the Kocher-Langenbeck approach.The two groups were compared in terms of operative time,intraoperative blood loss, reduction and functional recovery of the hip.Results The 30 patients obtained an average follow-up of 15 months(from 12 to 22 months).The research group reported significantly shorter operation time(3.17±0.23)hours and significantly less intraoperative bleeding(438±44.11)mL than the control group(3.93±0.32)hours and(683.33±88.53)mL respectively(P<0.05).According to modified Matta?s criteria for reduction, the research group had 12 excellent and 2 good cases,1 fair and 0 poor case(giving an excellent to good rate of 93.33%)while the control group had 12 excellent cases,1 good,1 fair and 1 poor case(giving an excellent to good rate of 86.67%).According to the modified Merle d?Aubigné and Postel scoring for the functional recovery of the affected hip at the final follow-ups,the research group had 13 excellent cases,1 good,1 fair and 0 poor case(giving an excellent to good rate of 93.33%) while the control group had 11 excellent cases,1 good,1 fair and 1 poor case(giving an excellent to good rate of 80.00%).There were no significant differences between the two groups in the above comparisons(P>0.05).There was no significant difference in postoperat
作者
蔡鸿儒
林世水
张旭鸣
王玲华
潘英
CAI Hongru;LIN Shishui;ZHANG Xuming;WANG Linghua;PAN Ying(Department of Emergency Surgery,Fujian Provincial Hospital,Fuzhou,Fujian 350001,China)
出处
《福建医药杂志》
CAS
2019年第4期16-21,共6页
Fujian Medical Journal
关键词
髋臼骨折
改良STOPPA入路
髂窝入路
髂坐螺钉
后柱
acetabulum fractures
modified Stoppa approach
iliac fossa approaches
antegradeilioschial screws
posterior column
