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1、临床医学论文-髓臼前壁骨折的治疗【摘要】〔目的〕探讨韻臼前壁骨折的治疗方法。〔方法〕自1989年6月〜2005年12月共收治競臼前壁骨折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例競臼前壁骨折患者，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；若骨折块较人，则用重建钢板
2、固定；骼前下棘骨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^ubigne和Postel髓关节评分标准。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扫描对于競臼前壁骨折的诊断价値比较人。骨折块较人、移位比较严重且伴有骯关节前脫位、关节内有游离肯块的韻臼前壁肯折需要手术治疗，手术入路以Smith-Petersen入路最
3、佳°【关键词】競关节；韻臼前壁；骨折；治疗Abstract:〔Objective〕Toexploretreatmentofacetabularanteriorwal1fractures・〔Method〕FromJune1989toDec.2005,8casesofacetabularanteriorwallfracturesweretreated.Thereweremale6cases,female2caseswithage16yearsto71years,average39.5years・Causeofinj
4、ury:trafficincidence5cases,fal1lease,crash2cases.Twocasesofacetabularanteriorwa11fractureswithsmal1displacementweretreatedbybonytraction6weeksto8weeks,followingstartingwalkingwiththecrutch6weeksto8weeks,andwalkingwithtotalweightwithoutsupport12weeksto16weeks
5、.SixpatientstreatedwithoperationthroughSmith-Petersenapproach:ifthefracturefragmentwassmall,itwasfixedwithlagscrewonly;ifthefracturefragmentwaslarge,ithadtobefixedwithreconstructionscrew.Thefractureofanteriorinferioriliacspinewassimplyfixedwithlagscrew.There
6、habi1itationprocessincludedwalkingwithcrutchnoweightbearing4weeks,thenpartialweight-bearwalkingwithcrutch6weeksto8weeks,finallywalkingwithoutcrutch3months・〔Result〕Al1patientswerefollowedup1yearto4years,average2years.Al1fracturesgotunionwell,andclinicalresult
7、swereevaluatedwithd'AubigneandPostelhipscorestandardwith5casesjointfunctionexcellentorgoodand1casereachedfairinoperationgroup.Theexcellentandgoodratewas83.33%andthejointfunctionwasexcellentinallcasesofnonoperationgroup.〔Conclusion〕CTscanhashighgreatdiagnosti
8、cvalueforacetabularanteriorwal1fractures.Acetabularanteriorwal1fractureswithlargefracturesegment,seriousdisplacement,femoralheaddislocation,orentrapmentofalargefreefracturefragmentinjointspace.T
