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1、实用骨科杂志第10卷,第6期,2004年12月·499·文章编号:1008-5572(2004)06-0499-03移位髋臼骨折手术治疗结果的分析12222王浩,卢汉生,吕智,赵瑜,刘晓彤(1.北京电力总医院骨科,北京100073;2.山西医科大学第二医院骨科,山西太原030001)摘要:目的探讨髋臼骨折的治疗方法。方法回顾性分析1990年1月至2002年5月收治的手术治疗156例移位髋臼骨折的临床和X线特征。130例作为研究对象。按Judel和Letournel的髋臼骨折分类标准,其中简单骨折36例,复杂骨折94例。单发伤52例,多发伤78例。手术时间为伤后21d以内,
2、平均8.2d。年龄13～89岁,平均46.5岁。130例均获得随访,平均随访1.5a。结果按Matta的复位标准,130例中,解剖复位87例(67%),满意27例(21%),不满意12例(9%)。髋臼双柱骨折“二次匹配”是4例(3%)。复位质量随年龄增加而不理想。根据HHS(Harrishipscore)评分,优54例(42%),良39例(30%),可17例(13%),差20例(15%)。87例解剖复位患者中有76例(89%)临床结果优良,37例可差患者中有28例(77%)为多发性损伤。结论解剖复位的髋臼骨折预后较好,特别是年轻患者,运用移位髋臼骨折手术治疗更具优越性。关
3、键词:髋臼;髋骨折;治疗结果;预后中图分类号:R683.3文献标志码:BAnalysisonOperativeTreatmentEffectivenessofDisplacedAcetabularFractures12b222WANGHao,LUHan2sheng,LUZhi,ZHAOYu,LIUXiao2tong(1.DepartmentofOrthopaedics,Beijingelectrichospital,Beijing100073,China;2.DepartmentofOrthopaedics,theSecondHospitalofShanxiMedical
4、University,Taiyuan030001,China)Abstract:ObjectiveTodisscussthetherapeuticmanagementofthedisplacedacetabualarfractures.MethodsThisstudyexaminedretrospectivelytheclinicalandradiographicfeaturesof156patientswithdisplacedacetabularfractures.130patientsmettheinclusioncriteria.AccordingtoJudeta
5、ndLetournel′sclassificationofacetabularfractures:36simpleand94complicatedfractures.Multipletraumawasfoundin78cases.Themeantimefromtheinjurytosurgerywas8.2days(range,0～21days).Themeanageofthepatientswas46.5years(range,13～89years).130caseswerefol2lowed2upforanaverageof1.5years.ResultsAccord
6、ingtoMatta′sreductioncriteria:anatomicin87(67%),imperfectin27(21%),poorin11(9%),andsecondarilycongruentin3both2columnfractures(3%).Thequalityofthereduc2tionsmarkedlydeferioratedwithadvancingage.AccordingtoHarrishipscore:excellentin54(42%),goodin39(30%),fairin17(13%),andpoorin20(15%).Excel
7、lentandgoodclinicalresultwererecordedin76(89%)of87pa2tientswithananatomicreduction.Ofthe37patientswithfairandpoorresults,28patients(77%)hadcomplicatingfac2torsrecognizableatclinicalpresentation,includingarticularabrasion,afemoralheadofneckfractureandsoon.Conclu2sion
