微创插板内固定治疗髋臼前柱骨折

发布时间：2019-04-18 18:29

【摘要】：[目的]探讨采用髂腹股沟入路微创切口插板内固定治疗髋臼前柱骨折的临床疗效及优缺点。[方法]2014年5月~2016年2月,本院收治髋臼前柱骨折患者24例,采取耻骨上支和髂嵴两处小切口,行骨膜下剥离,形成髂骨嵴经髋臼前柱到耻骨支的隧道,根据髋臼前柱正常解剖结构,预折弯重建钢板放入隧道内,在耻骨上支给予2枚螺钉固定,维持髋臼前柱解剖连续性,在髂骨翼处给予3枚左右拉力螺钉,对髋臼前柱骨折端起到加压作用。[结果]随访6~39个月,平均16.9个月,骨折均愈合,术后按照Matta复位标准评定:优19例,良4例,可1例,总优良率95.8%,髋关节功能情况根据改良D,Aubigne-Postel髋关节功能评分标准评定:优18例,良5例,可1例,差1例,优良率为91.7%。[结论]髂腹股沟微创入路插板内固定治疗髋臼前柱骨折是一种可行的方法,具有创伤小、手术时间短、出血少,可显著改善髋关节功能的优点。
[Abstract]:[objective] to investigate the clinical efficacy, advantages and disadvantages of minimally invasive incision plate fixation through ilioinguinal approach in the treatment of acetabular anterior column fractures. [methods] from May 2014 to February 2016, 24 patients with acetabular anterior column fracture were treated in our hospital. Two small incision of superior pubic branch and iliac crest were performed, and subperiosteal dissection was performed to form a tunnel from anterior column of acetabular to pubic branch of iliac crest. According to the normal anatomical structure of the acetabular anterior column, the pre-bending reconstruction plate was placed into the tunnel and fixed with 2 screws in the superior pubic branch to maintain the anatomical continuity of the acetabular anterior column, and 3 left and right lag screws were given to the pterygoid of the iliac bone. To the acetabular anterior column fracture end to play the pressure function. [results] all fractures healed after a follow-up of 6 to 39 months (average 16.9 months). According to Matta reduction criteria, 19 cases were excellent, 4 cases were good, 1 case was fair, the total excellent and good rate was 95.8%, the function of hip joint was according to the modified D. According to Aubigne-Postel hip function score, 18 cases were excellent, 5 cases were good, 1 case was fair, and 1 case was bad. The excellent and good rate was 91.7%. [conclusion] Ilioinguinal minimally invasive internal fixation for acetabular anterior column fracture is a feasible method. It has the advantages of less trauma, shorter operation time and less bleeding, which can significantly improve the function of hip joint.
【作者单位】：郑州市骨科医院;
【基金】：郑州市普通科技公关计划项目(编号:141PPTGG326)
【分类号】：R687.3

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