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1、髋臼前后柱拉力螺钉结合重建钢板固定治疗髋臼横断骨折作者：郑琦毕大卫徐荣明李明魏威汪翼凡【摘要】目的回顾分析髋臼前后柱螺钉结合重建钢板固定治疗髋臼横断骨折的疗效。方法本组患者共36例，采用Kochher-Langenback入路14例，髂腹股沟入路12例，扩展型髂股入路6例，前后联合入路4例。本组病例中采用后路重建钢板结合前柱螺钉固定21例，前路重建钢板结合后柱螺钉固定15例。结果随访时间6～27个月，平均19.6个月。复位评估参照Matta标准，解剖复位22例（61.11％）；满意复位10例（27.78％）；复位不满意4例（11.11％）。关节功能按
2、改良MerledAubigne6分法和Epstein标准评定,优23例(63.89%)，良8例(22.22%)，可3例(8.33%)，差2例(5.56%)，优良率86.11％。异位骨化4例，按Brooker分级:I～II级3例，III～IV级1例。深静脉栓塞2例，经非手术治疗而愈，坐骨神经医源性损伤1例，经治疗6月后恢复，股骨头坏死3例。结论髋臼前后柱螺钉固定结合钛板治疗髋臼横断骨折，创伤较少，固定坚强，治疗效果良好。【关键词】髋臼横断骨折内固定拉力螺钉 【Abstract】ObjectiveToanalysetheoutcomeofinterna
3、lfixationwithlagscrewforanteriororposteriorcolumnoftheacetabulumandreconstructionplateintransverseacetabularfractureretrospectively.MethodsThirty-sixcasesoftransverseacetabularfracturesweretreatedwithopenreductionandinternalfixation.Kocher－Langenbeckapproachwereadoptedin14cases
4、,theilioinguinalapproachin12cases,extendediliofemoralapproachin6case,combinationwithanteriorandposteriorapproachin4cases.21patientswerefixedbyposteriorreconstructionplatecombinedwithanteriorlagscrews,theotherswerefixedwithanteriorreconstructionplatecombinedwithposteriorlagscrew
5、s.ResultsTheaveragefollow-uptimewas19.6monthswithrangefrom6monthsto32months.AccordingtoMattastandard,anatomyreductionwereobtainedin22cases(61.11%),satisfactoryreduction10cases(27.78%),unsatisfactory6cases(11.11%).BasedonMerledAubigneandEpsteinstandardassessment,23patientsachiev
6、edexcellentresults(63.89%),good8(22.22%),fair3(8.33%),poor2(5.56%).Excellentandgoodrateswas86.11%.Heterotopicossificationoccurredin4cases,inwhichBrookergradeI～IIwere3cases,III~IV1cases.Thereweredeepveinthrombusin2cases,Sciaticnerveinjurywasseenin1casesandwasrecovered6monthslate
7、r,Theywereallfurthertreatedbyconservativetreatments.4Avascularnecrosisofthefemoralheadwasfoundin3cases.ConclusionItshowsthatthetransverseacetabularfracturestreatedbythecombinationofanteriororposteriorlagscrewandTi-plateislessinvasiveandmorestrongaswell.Theclinicalresultsarealso
8、excellent. 【Keywords】TransverseacetabularfractureInte
