摘要
目的比较改良Stoppa入路与髂腹股沟入路钢板内固定治疗髋臼前柱/前壁骨折的临床疗效。方法采用回顾性病例对照研究分析2014年10月至2019年1月河北医科大学第三医院收治的39例髋臼前柱/前壁骨折患者临床资料,其中男32例,女7例;年龄21~80岁[(49.6±13.7)岁]。前柱骨折31例,前壁骨折6例,前柱伴前壁骨折2例。22例采用改良Stoppa入路钢板内固定治疗(A组),17例采用髂腹股沟入路钢板内固定治疗(B组)。比较手术时间和术中出血量;依照Matta评分评估骨折复位质量;末次随访根据改良Merle D'Aubigné-Postel评分标准评定髋关节功能;观察术后并发症发生情况。结果患者均获随访13~50个月[(32.4±10.5)个月]。A组手术时间为(152.1±47.5)min,术中出血量为(497.7±160.7)ml,均低于B组的(192.1±58.2)min、(638.2±166.3)ml(P<0.05)。A组骨折Matta评分复位优良率为86%(19/22),末次随访时改良Merle D'Aubigné-Postel评分髋关节功能优良率为82%(18/22),B组分别为82%(14/17)、77%(13/17)(P均>0.05)。术后A组下肢深静脉血栓1例,股外侧皮神经损伤1例,闭孔神经损伤1例;B组下肢深静脉血栓2例,股外侧皮神经损伤2例,创伤性关节炎1例。A组并发症发生率为14%(3/22),B组为29%(5/17)(P>0.05)。结论对于髋臼前柱/前壁骨折,采用改良Stoppa入路和髂腹股沟入路钢板内固定均能获得满意疗效,但改良Stoppa入路具有手术时间短、术中出血量少等优点,值得临床推广。
Objective To compare the clinical effect of modified Stoppa approach and Ilioinguinal approach for acetabular anterior column/wall fractures treated with plate internal fixation.Methods A retrospective case-control study was conducted to assess the data of 39 patients with acetabular anterior column/wall fractures surgically treated at Third Hospital of Hebei Medical University from October 2014 to January 2019.There were 32 males and 7 females,with a mean age of 21-80 years[(49.6±13.7)years].According to Judet-Letournel classification,the fracture type was anterior column in 31 patients,anterior wall in 6 and anterior column combined anterior wall in 2.Twenty-two patients were treated with modified Stoppa approach(Group A)and 17 patients were treated with ilioinguinal approach(Group B).The operation time and blood loss were recorded.The quality of reduction was assessed by Matta criteria.Functional outcome of the hip was evaluated using Modified Merle D'Aubigne-Postel score at the latest follow-up.Complications in the two groups were documented.Results All patients were followed up for 13-50 months[(32.4±10.5)months].The operation time[(152.1±47.5)minutes]and blood loss[(497.7±160.7)ml]in Group A were significantly lower than those in GroupB[(192.1±58.2)minutes,(638.2±166.3)ml](P<0.05).According to Matta criteria and D'Aubigne-Postel score,the good and excellent rates of reduction quality and functional outcome in Group A were 86%(19/22)and 82%(18/22),higher than that in GroupB[82%(14/17),77%(13/17)](P>0.05).In Group A,postoperative deep vein thrombosis of lower extremity was found in I patient,lateral femoral cutaneous nerve injury in 2,and obturator nerve injury in 3.In Group B,there were 2 patients with lower extremity deep vein thrombosis,1 lateral femoral cutaneous nerve injury,and 3 traumatic arthritis.The complication rate was 14%(3/22)in Group A and 29%(5/17)in Group B(P>0.05).Conclusions For acetabular anterior column/wall fractures,both modified Stoppa approach and ilioinguinal approach with plat
作者
田思宇
王忠正
赵阔
张瑞鹏
尹英超
侯志勇
张英泽
Tian Siyu;Wang Zhongzheng;Zhao Kuo;Zhang Ruipeng;Yin Yingchao;Hou Zhiyong;Zhang Yingze(Center of Trauma and Emergency,Orthopedic Research Institute of Hebei Province,Hebei Provincial Key Laboratory of Orthopedic Biomechanics,Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2020年第11期977-982,共6页
Chinese Journal of Trauma
基金
国家重点研发计划(2019YFC0120600)。
关键词
髋臼
骨折
骨折固定术
内
Acetabulum
Fractures,bone
Fracture fixation,internal
