W型髋臼角钢板与重建钢板治疗髋臼后壁骨折的前瞻性比较

发布时间：2018-06-30 04:49

本文选题：后壁 + 髋臼骨折　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:传统上髋臼后壁骨折的手术治疗常使用一块或者两块重建钢板,有时还需联合使用弹性钢板。为了能够省去使用弹性钢板并让手术操作变得更加便利,本研究将介绍一种新的内固定装置即W型髋臼角钢板,并经过最少术后1年随访,前瞻性比较W型髋臼角钢板与传统重建钢板治疗髋臼后壁骨折的临床效果。方法:本研究最终共纳入55例单纯髋臼后壁骨折患者,其中29例采用W型髋臼角钢板进行治疗,另外26例则采用传统重建钢板进行治疗,详细记录并比较两组病人的人口统计学资料、手术细节、住院时间、手术相关并发症以及术后1年的髋关节功能和影像学评分。结果:两组病人均获得了最后的骨性愈合,且二者在住院时间和并发症发生率方面无明显差异。术后1年末次随访发现两组病人的髋关节功能及影像学结果亦无明显差异。然而,W型髋臼角钢板组的平均手术时间(133.7±31.1 min)、出血量(562.1±290.8 ml)、透视时间(15.9±2.7 s)以及螺钉误置率(6.9%)均明显少于传统重建钢板组(181.9±37.4 min,823.1±258.2ml,31.4±3.3 s,38.5%;P0.05)。结论:我们的研究表明,W型髋臼角钢板可有效用于治疗髋臼后壁骨折。与传统重钢板相比,该新型内固定系统具有手术时间与透视时间短、出血量少以及螺钉误置率低等优点。
[Abstract]:Objective: traditional surgical treatment of posterior acetabular fractures is usually performed with one or two reconstructive plates, sometimes with elastic plates. In order to save the use of elastic plate and make the operation more convenient, this study will introduce a new internal fixation device, the W-shaped acetabular plate, and be followed up for at least one year after operation. To prospectively compare the clinical effect of W type acetabular angle plate and traditional reconstruction plate in the treatment of acetabular posterior wall fracture. Methods: a total of 55 patients with acetabular posterior wall fractures were included in this study, 29 of whom were treated with W acetabular angle plate and 26 with traditional reconstruction plate. The demographic data, surgical details, length of stay, operative complications, hip function and imaging scores were recorded and compared in both groups. Results: the final bony healing was achieved in both groups, and there was no significant difference in the length of hospitalization and the incidence of complications between the two groups. There was no significant difference in hip function and imaging results between the two groups. However, the mean operative time (133.7 卤31.1 min),) and the screw misplacement rate (6.9%) in the W type acetabular angle plate group were significantly lower than those in the conventional reconstruction plate group (133.7 卤31.1 min), 562.1 卤290.8 ml), fluoroscopy time, 15.9 卤2.7s and 6.9%, respectively) (181.9 卤37.4 mins, 823.1 卤258.2 ml, 31.4 卤3.3s38.5ml, P0.05). Conclusion: our study shows that W-type acetabular angle plate can be used to treat acetabular posterior wall fracture effectively. Compared with the traditional heavy plate, the new internal fixation system has the advantages of short operation time and fluoroscopy time, less bleeding and low screw misplacement rate.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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