摘要
目的探讨微型钢板联合重建接骨板治疗粉碎性髋臼后壁骨折的临床疗效。方法采用回顾性病例系列研究分析2015年10月至2019年6月解放军中部战区总医院收治的27例粉碎性髋臼后壁骨折患者的临床资料,其中男18例,女9例;年龄23~61岁[(45.9±10.9)岁]。均采用微型钢板联合重建接骨板内固定治疗。记录手术时间、术中出血量、术中输血量、住院时间、骨折愈合时间。术后2 d采用Matta影像学评估标准评价骨折复位情况。术后3,6个月及末次随访时采用改良Merle D’’Aubigné-Postel评分系统评估患侧髋关节功能。观察并发症发生情况,根据Brooker分级评估异位骨化情况。结果患者均获随访12~48个月[36(24,36)个月]。手术时间为123~242 min[(165.4±29.8)min];术中出血量为170~550 ml[(358.3±111.3)ml];9例需要术中输血,输血量为300~500 ml[(377.8±66.7)ml]。住院时间为12~29 d[(21.4±4.7)d]。骨折愈合时间为12~24周[(16.3±3.0)周]。术后2 d Matta影像学评估标准评价:优21例,良3例,差3例,复位优良率为89%。术后3个月改良Merle D’’Aubigné-Postel评分为9~16分[(13.1±1.9)分],6个月为10~18分[(15.4±2.0)分],末次随访时为12~18分[(16.9±1.8)分](P<0.01);术后3个月与6个月差异有统计学意义(P<0.01),末次随访与术后6个月差异有统计学意义(P<0.01)。术后3个月改良Merle D’’Aubigné-Postel评分优0例,良7例,可11例,差9例,优良率为26%;6个月优3例,良19例,可2例,差3例,优良率为81%;末次随访时优18例,良5例,可3例,差1例,优良率为85%(P<0.01)。术后无医源性坐骨神经损伤、下肢深静脉血栓形成及切口感染并发症发生。随访过程中未见内固定松动移位和骨折复位丢失并发症发生。发生创伤性关节炎2例。股骨头缺血性坏死1例并行全髋关节置换术。异位骨化3例,其中Brooker分级Ⅰ级2例,Ⅱ级1例,均未对髋关节功能产生不利影响。结论微型钢板联合重建接骨板�
Objective To evaluate the clinical results of miniplates combined with reconstruction plate in treating comminuted posterior wall acetabular fractures.Methods A retrospective case series study was conducted for 27 patients with comminuted posterior wall acetabular fractures treated in General Hospital of Central Theatre Command of PLA from October 2015 to June 2019.There were 18 males and 9 females,at age of 23-61 years[(45.9±10.9)years].All patients were treated by using miniplates combined with the reconstruction plate.The operation time,intraoperative blood loss,intraoperative blood transfusion,length of hospital stay and time of fracture healing were recorded.The reduction quality was evaluated according to Matta radiographic standard at 2 days postoperatively.The modified Merle D'Aubigné-Postel score was adopted to evaluate the hip function at 3,6 months postoperatively and the final follow-up.Postoperative complications were observed,and heterotopic ossification was assessed by Brooker grading standard.Results All patients were followed up for 12-48 months[36(24,36)months].The operation time was 123-242 minutes[(165.4±29.8)minutes];the intraoperative blood loss was 170-550 ml[(358.3±111.3)ml];nine patients required intraoperative blood transfusion of 300-500 ml[(377.8±66.7)ml].The length of hospital stay was 12-29 days[(21.4±4.7)days].The fracture healing time was 12-24 weeks[(16.3±3.0)weeks].According to Matta radiographic standard,the reduction quality was excellent in 21 patients,good in 3 and poor in 3 at 2 days postoperatively,with the excellent rate of 89%.The modified Merle D'Aubigné-Postel score was 9-16 points[(13.1±1.9)points]at 3 months postoperatively,was 10-18 points[(15.4±2.0)points]at 6 months postoperatively,and was 12-18 points[(16.9±1.8)points]at last follow-up(P<0.01).The modified Merle D'Aubigné-Postel score between 3 months and 6 months was significantly different(P<0.01),and the difference between 6 months and the follow-up was statistically significant(P<0.01).The modified
作者
郑益钒
钱胜龙
柯烯
陈嘉楠
汪国栋
刘曦明
蔡贤华
Zheng Yifan;Qian Shenglong;Ke Xi;Chen Jianan;Wang Guodong;Liu Ximing;Cai Xianhua(Department of Orthopedics,General Hospital of Central Theater Command of PLA,Wuhan 430070,China;First School of Clinical Medicine,Southern Medical University,Guangzhou 510515,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2021年第12期1083-1089,共7页
Chinese Journal of Trauma
基金
卫勤保障能力创新与生成专项(20WQ034)。
关键词
髋臼
骨折
粉碎性
骨折固定术
内
微型钢板
Acetabulum
Fractures,comminuted
Fracture fixation,internal
Miniplates
