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1、·838·ChineseJournalofReparativeandReconstructiveSurgery,2006,Vol20(8)改良髂股延长入路治疗复杂髋臼骨折蔚艹凡宋超敏明伟吴青【摘要】目的探讨改良髂股延长入路在复杂髋臼骨折切开复位内固定中的作用。方法1999年6月～2005年12月,36例髋臼骨折按Letournel2Judute分型,其中前壁+横形9例,T形5例,横形+后壁11例,双柱6例,前壁+前柱+后壁+后柱5例;合并股骨头脱位13例;病程1～3周。均采用改良髂股延长入路行切开复位内固定治疗。结果术后均获7～46个月临床随访,平均23.8个月。X线片骨折复位按
2、Matta复位标准,其中解剖复位24例,良好复位8例,差复位4例。根据改良的d'Aubigne和Postel的髋臼骨折临床评分标准获优22例,良好9例,较差5例。结论改良髂股延长入路在复杂髋臼骨折切开复位时,能同时显露髋臼的前壁、前柱和后壁、后柱,同时采用骨与骨的方式重建外展肌群的起止点,使患肢能够早期活动,有利于髋臼的磨造和髋关节功能的恢复。【关键词】改良髂股延长入路髋臼骨折修复重建中图分类号:R68313R687143文献标识码:ATREATMENTOFCOMPLEXACETABULARFRACTURESBYAMODIFIEDEXTENDEDILIOFEMORALAPPROA
3、CHöWEIPeng,SONGChaoming,MINGWei,etal.DepartmentofOrthopedics,AffiliatedHospitalofNorthSichuanMedicalCollege,NanchongSichuan,637000,P.R.ChinaCorrespondingauthor:WEIPeng【Abstract】ObjectiveToevaluatetheeffectofthemodifiedextendediliofemoralapproachontreatingcomplexacetabularfractures.MethodsThir
4、ty2sixcasesofcomplexacetabularfracturesweretreatedbytheopenrepositionandinternalfixationbyamodifiedextendediliofemoralapproach.ResultsThirty2sixcaseswerefollowedupfor7246months,withanaverageof23.8months.AccordingtotheMattastandard,anatomicalrepositionwasperformedin24cases,perfectrepositionin8
5、cases,andunsatisfactoryrepositionin4cases.Bythemodifiedd'Aubigne2postelscore,amongthe36cases,22hadanexcellentresult,9hadagoodresult,and5hadapoorresult.ConclusionThemodifiedextendediliofemoralapproachfacilitatestheoperativeexposureoftheanteriorandposteriorwallsandbothcolumnsoftheacetabuluminth
6、esurgically2treatedacetabularfracturesbytheopenrepositionandinternalfixation.Becauseofthereconstruction,thefunctionsoftheabductormusclemassmanagedbythelagscrew2fixedosteotomiesoftheiliaccrest,andgreatertrochanter,thepatientscanachievearapidrehabilitationofthejoint.【Keywords】Modifiedextendedil
7、iofemoralapproachAcetabularfractureRepairandreconstruction我们于1999年6月～2005年12月采用改良的髂1例。病程1～3周。股延长入路治疗复杂髋臼骨折36例,获得了良好的效1.2手术方法果。报告如下。首先治疗危及生命的合并损伤。所有患者常规行X线前后位、Judet左右斜位片及CT扫描。均行股骨1临床资料髁上牵引,常规术前实验室检查。[1]1.1一般资料患者全麻后采用Routt等推荐的“懒散侧卧[2]本组36例,男27例
