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1、髋臼前壁骨折的治疗【摘要】［目的］探讨髋臼前壁骨折的治疗方法。［方法］自1989年6月～2005年12月共收治髋臼前壁骨折8例，其中，男6例，女2例。年龄16～71岁，平均39.5岁。致伤原因：车祸伤5例，坠落伤1例，砸伤2例。其中2例采用非手术治疗，6例采用手术治疗。对移位不大的2例髋臼前壁骨折患者，采用骨牵引6～8周，扶拐逐渐负重行走6～8周，12～16周后弃拐完全负重行走。采用手术治疗者手术入路均采用Smith-Petersen入路，若骨折块较小，仅用拉力螺钉固定；若骨折块较大，则用重建钢板固定；髂前下棘骨
2、折和碎骨块用拉力螺钉固定。4周后扶拐不负重行走，然后扶拐逐渐负重行走6～8周，一般术后3个月可弃拐行走。［结果］随访1～4年，平均2年，骨折均获得良好愈合，临床结果评价采用d'Aubigne和Postel髋关节评分标准。结果手术治疗组关节功能表现优良者5例，可1例，优良率为83.33％。非手术治疗的2例关节功能表现优。［结论］CT扫描对于髋臼前壁骨折的诊断价值比较大。骨折块较大、移位比较严重且伴有髋关节前脱位、关节内有游离骨块的髋臼前壁骨折需要手术治疗，手术入路以Smith-Petersen入路最佳。【关键词】髋
3、关节；髋臼前壁；骨折；治疗Abstract：［Objective］Toexploretreatmentofacetabularanteriorwallfractures.［Method］FromJune1989toDec.2005,8casesofacetabularanteriorwallfracturesweretreated.Thereweremale6cases,female2caseswithage16yearsto71years,average39.5years.Causeofinjury:traff
4、icincidence5cases,fall1case,crash2cases.Twocasesofacetabularanteriorwallfractureswithsmalldisplacementweretreatedbybonytraction6weeksto8weeks,followingstartingwalkingwiththecrutch6weeksto8weeks,andwalkingwithtotalweightwithoutsupport12weeksto16weeks.Sixpatien
5、tstreatedwithoperationthroughSmith-Petersenapproach:ifthefracturefragmentwassmall,itwasfixedwithlagscrewonly;ifthefracturefragmentwaslarge,ithadtobefixedwithreconstructionscrew.Thefractureofanteriorinferioriliacspinewassimplyfixedwithlagscrew.Therehabilitatio
6、nprocessincludedwalkingwithcrutchnoweightbearing4weeks,thenpartialweight-bearwalkingwithcrutch6weeksto8weeks,finallywalkingwithoutcrutch3months.［Result］Allpatientswerefollowedup1yearto4years,average2years.Allfracturesgotunionwell,andclinicalresultswereevaluat
7、edwithd'AubigneandPostelhipscorestandardwith5casesjointfunctionexcellentorgoodand1casereachedfairinoperationgroup.Theexcellentandgoodratewas83.33%andthejointfunctionwasexcellentinallcasesofnonoperationgroup.［Conclusion］CTscanhashighgreatdiagnosticvalueforacet
8、abularanteriorwallfractures.Acetabularanteriorwallfractureswithlargefracturesegment,seriousdisplacement,femoral4headdislocation,orentrapmentofalargefreefracturefragmentinjointspace.Thebes
