摘要
目的探讨单独应用改良Stoppa入路或结合髂窝入路治疗髋臼骨折的近期疗效。方法回顾性分析2016年1月至2019年10月期间北京积水潭医院创伤骨科收治的36例髋臼骨折患者资料。男28例,女8例;平均年龄为45.2岁(27~78岁);左侧15例,右侧21例。骨折按Judet-Letournel分型:前柱骨折13例,前柱加前壁骨折3例,双柱骨折12例,前方加后半横形骨折6例,T形骨折2例。受伤至手术时间平均为6 d(2~12 d)。所有患者采用单独改良Stoppa入路或结合髂窝入路行切开复位钢板螺钉内固定。根据Matta评分标准评定术后骨折复位质量。记录并比较患者术前与术后18个月的疼痛视觉模拟评分(VAS)。记录患者的骨折愈合时间、末次随访时髋关节Harris评分及并发症发生情况等。结果本组患者的手术时间平均为213.2 min(110~340 min)。根据Matta评分标准评定术后骨折复位质量:解剖复位28例,满意复位8例。36例患者术后获平均20个月(18~25个月)随访。36例患者术后18个月时VAS评分为(0.7±0.6)分,显著低于术前[(6.7±1.3)分],差异有统计学意义(P<0.05)。36例患者的骨折愈合时间平均为3.2个月(1.5~6.0个月)。末次随访时36例患者的髋关节Harris评分为80~95分,平均90.6分;优26例,良10例。随访期间无一例患者出现内固定失效、神经血管损伤等严重并发症。结论单独应用改良Stoppa入路或结合髂窝入路治疗髋臼骨折的近期疗效良好,可以安全、有效地处理同时累及髋臼前、后柱的骨折。
Objective Toevaluate the short-term outcomes of mere modified Stoppa approach or in addition to ilia fossa approach for acetabular fractures.Methods From January 2016 to October 2019,36 patients with acetabular fracture were treated at Department of Traumatology and Orthopaedics,Beijing Jishuitan Hospital.They were 28 males and 8 females with an average age of 45.2 years(from 27 to 78 years).The left side was affected in 15 cases and the right side in 21.By the Judet-Letournel classification,there were 13 anterior column fractures,3 anterior column and wall fractures,12 both-column fractures,6 anterior and posterior hemitransverse fractures,and 2 T-shaped fractures.The time from injury to surgery averaged 6 days(from 2 to 12 days).All the patients were treated by open reduction and plate-screw fixation through the mere modified Stoppa approach or in addition to the ilia fossa approach.The quality of postoperative fracture reduction was evaluated according to the Matta score.The pain scores of visual analogue scale(VAS)for the patients before operation and 18 months after operation were recorded and compared.The fracture healing time,Harris hip score at the last follow-up and complications in the patients were recorded.Results The average operation time in this cohort was 213.2 min(from 110 to 340 min).By the Matta scores,anatomical reduction was achieved in 28 cases and satisfactory reduction in 8.The 36 patients were followed up for an average of 20 months(from 18 to 25 months).Their VAS pain scores at 18 months after operation were(0.7±0.6)points,significantly lower than those before operation[(6.7±1.3)points](P<0.05).Their fracture healing time averaged 3.2 months(from 1.5 to 6.0 months).Their Harris hip scores at the last follow-up averaged 90.6 points(from 80 to 95 points),yielding 26 excellent and 10 good cases.There were no serious complications like internal fixation failure or neurovascular injury during the follow-up period.Conclusions In the treatment of acetabular fractures,simple modified Stoppa ap
作者
李绍良
苏永刚
王满宜
Li Shaoliang;Su Yonggang;Wang Manyi(Department of Traumatology and Orthopaedics,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第3期219-224,共6页
Chinese Journal of Orthopaedic Trauma
关键词
髋臼
骨折
骨折固定术
内
骨板
骨钉
改良STOPPA入路
切开复位
Acetabulum
Fractures,bone
Fracture fixation,internal
Bone plates
Bone nails
Modified Stoppa approach
Open fracture reduction
