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[1]蔡鴻儒 林世水 張旭鳴 王玲華 潘 英.改良Stoppa入路聯(lián)合髂窩入路順行髂坐螺釘治療累及后柱的 復(fù)雜髖臼骨折[J].福建醫(yī)藥雜志,2019,41(04):16-21.
　CAI Hongru,LIN Shishui,ZHANG Xuming,et al.Treatment of complex acetabular fractures involving the posterior column with antegradeilioschial screws via modified Stoppa and iliac fossa approaches[J].FUJIAN MEDICAL JOURNAL,2019,41(04):16-21.
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改良Stoppa入路聯(lián)合髂窩入路順行髂坐螺釘治療累及后柱的 復(fù)雜髖臼骨折()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
41
期數(shù):
2019年04期
頁碼:
16-21
欄目:
臨床研究
出版日期:
2019-08-15

文章信息/Info

Title:
Treatment of complex acetabular fractures involving the posterior column with antegradeilioschial screws via modified Stoppa and iliac fossa approaches
文章編號:
1002-2600(2019)04-0016-06
作者:
蔡鴻儒1; 2 林世水1; 2 張旭 鳴1; 2 王玲華 潘 英
福建省立醫(yī)院急診外科(福州 350001)
Author(s):
CAI Hongru; LIN Shishui; ZHANG Xuming; WANG Linghua; PAN Ying
Department of Emergency Surgery,Fujian Provincial Hospital,Fuzhou,Fujian 350001,China
關(guān)鍵詞:
髖臼骨折;  改良Stoppa入路;  髂窩入路;  髂坐螺釘;  后柱
Keywords:
acetabulum fractures;  modified Stoppa approach;  iliac fossa approaches;  antegradeilioschial screws;  posterior column
分類號:
R683.3
文獻標(biāo)志碼:
B
摘要:
目的 探討采用改良Stoppa入路聯(lián)合髂窩入路順行髂坐螺釘治療累及后柱的復(fù)雜 髖臼骨折的臨床療效。方法 回顧性分析2014年1月至2017年12月收治的30例復(fù)雜髖臼骨折患 者的臨床資料。根據(jù)手術(shù)方式不同將患者分為研究組與對照組。研究組采用改良Stoppa入路 聯(lián)合髂窩入路,分別于髂恥柱鋪設(shè)鋼板穩(wěn)定前柱及骨盆內(nèi)側(cè)植入髂坐螺釘固定后柱骨折。對 照組采用前方改良Stoppa入路聯(lián)合后方Kocher-Langenbeck入路,分別于髂恥柱鋪設(shè)鋼板穩(wěn)定 前柱及后方重建鋼板固定后柱骨折。比較兩組患者的臨床療效。結(jié)果 研究組手術(shù)時間及術(shù) 中出血量均明顯少于對照組,差異均有統(tǒng)計學(xué)意義(P<0.05)。按改良Matta標(biāo)準評 定術(shù)后骨折復(fù)位質(zhì)量,研究組優(yōu)良率為 93.33%,對照組優(yōu)良率為86.67%; 按改良的 Merle d Aubigné和Postel功能評分系統(tǒng)評定術(shù)后1年隨訪時患髖功能,研究組優(yōu)良率為 93.33%; 對照組優(yōu)良率為80.00%。以上兩個項目患者優(yōu)良率比較,差異均無統(tǒng)計學(xué)意義。術(shù) 后并發(fā)癥發(fā)生率比較,差異無統(tǒng)計學(xué)意義(P>0.05)。結(jié)論 對于累及后柱的復(fù)雜髖 臼骨折,改良Stoppa入路聯(lián)合髂窩入路順行髂坐螺釘具有手術(shù)時間短、術(shù)中出血量少、固定 牢靠、損傷小等優(yōu)點,是一種理想的手術(shù)方式。
Abstract:
Objective To investigate the effectiveness of antegradeilioischial screws through modified Stoppa and iliac fossa approaches for complex acetabular fractures involving the posterior column.Methods A consecutive series of 30 patients with complex acetabular fracture were treated operatively from January 2014 to December 2017.Of them,15 were treated through modified Stoppa plus iliac fossa approaches as the research group.The anterior column was stabilized with a reconstruction plate for the iliac wing along the iliopectineal line to the pubis in all cases.The posterior column was fixed with antegradeilioischial screws.The other 15 patients served as the control group, treated with a reconstruction plate for the conventional posterior column fixation through the Kocher-Langenbeck approach.The two groups were compared in terms of operative time,intraoperative blood loss, reduction and functional recovery of the hip.Results The 30 patients obtained an average follow-up of 15 months(from 12 to 22 months).The research group reported significantly shorter operation time (3.17±0.23)hours and significantly less intraoperative bleeding (438±44.11)mL than the control group(3.93±0.32)hours and (683.33±88.53)mL respectively(P<0.05).According to modified Matta s criteria for reduction, the research group had 12 excellent and 2 good cases,1 fair and 0 poor case(giving an excellent to good rate of 93.33%)while the control group had 12 excellent cases,1 good,1 fair and 1 poor case(giving an excellent to good rate of 86.67%).According to the modified Merle dAubigné and Postel scoring for the functional recovery of the affected hip at the final follow-ups,the research group had 13 excellent cases,1 good,1 fair and 0 poor case(giving an excellent to good rate of 93.33%)while the control group had 11 excellent cases,1 good,1 fair and 1 poor case(giving an excellent to good rate of 80.00%).There were no significant differences between the two groups in the above comparisons(P>0.05).There was no significant difference in postoperative complication rate between the research group and the control group.Conclusion Antegradeilioschial screws via modified Stoppa and iliac fossa approaches has advantages of short operation time, less intraoperative blood loss, reliable fixation and limited invasion. It is an ideal operation method for complex acetabular fractures involving the posterior column.

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相似文獻/References:

[1]林世水,李建華,何林盛,等.腹直肌旁入路與改良Stoppa入路治療髖臼骨折的臨床效果比較[J].福建醫(yī)藥雜志,2021,43(01):45.

備注/Memo

備注/Memo:
1 福建醫(yī)科大學(xué)省立臨床醫(yī)學(xué)院; 2 福建省急診醫(yī)學(xué)研究所
更新日期/Last Update: 2019-08-15