评估髋臼骨折的手术疗效及相关因素.docVIP

评估髋臼骨折的手术疗效及相关因素 作者：李宁，杜远立，梁杰，王华，黄鹤 作者单位：(宜昌市第一人民医院骨科，湖北 宜昌 443000) 【摘要】 目的 评估髋臼骨折的手术疗效及影响手术疗效的相关因素。方法 回顾整理1999年3月至2004年10月期间63 例因髋臼骨折在我院行手术治疗患者的流行病学及并发症资料。结果 52 例患者(82.54％)至少合并1个其他部位的损伤。14 例患者(22.22％)有坐骨神经损伤表现。29 例患者(46.03％)有术后并发症但大多数没有影响手术效果。再手术率4％。59 例患者(93.65％)有门诊随访和X线片复查结果，平均随访时间为2年4个月。44 例患者(69.84％)的疗效为优/好。结论 疗效优/好的与早期手术和解剖复位等因素相关。疗效差的与手术延迟、复位失败或内固定不牢靠以及受伤时合并股骨头骨折等因素相关。 【关键词】 髋臼骨折；解剖复位；内固定 Evaluation of the Outcome of Operative Management of Acetabular Fractures and Related Factors LI Ning，DU Yuanli，LIANG Jie，et al (Department of Orthopaedics The First People′s Hospital of Yichang City，Yichang 443000，China) Abstract：Objective The aim of this study was to evaluate the outcome of operative management of acetabular fractures and relating factors.Methods We reviewed the epidemiology and complications of 63 patients who had operative treatment for acetabular fracture undertaken at our hospital from May 1999 to October 2004.Results Fiftytwo patients(82.5％) had an injury of at least one other system.Fourteen patients(22.22％) had a sciatic nerve injury on presentation.Twentynine patients(46.03％) had a postoperative complication，but this did not affect the outcome in the majority.The reoperation rate was 4％.Fiftynine patients(93.65％) had clinical and radiological followup for a mean of 2.4 years.Fortyfour patients(69.84％) had a good or excellent result.Conclusion Good or excellent outcome was associated with early operation and anatomical reduction.Poor outcome was associated with delay to surgery，failure to achieve or maintain reduction，and femoral head fracture at the time of injury. Key words：fracture of acetabulum；anatomical reduction；internal fixation 髋臼骨折的治疗在过去的数十年内有了不少变化，有移位的髋臼骨折现在主张早期手术治疗［1］。骨盆和髋臼骨折在所有骨折里占2％，但是因为高能量的损伤，患者往往同时伴随其他系统的外伤，如内脏器官的损伤、神经血管和关节的损伤等，所以骨盆有髋臼骨折总是伴随着相对高的致残率和死亡率［2］。有移位的髋臼骨折手术治疗能缩短患者卧床的时间和住院天数，降低并发症的概率，降低致残率。很多学者报道了髋臼骨折的精确复位和手术疗效的显著相关性［3］。 1 资料与方法 1.1 一般资料 1999年3月至2004年10月期间所有在我院行髋臼骨折开放复位内固定手术的患者都