[1]蔡鸿儒 林世水 张旭鸣 王玲华 潘 英.改良Stoppa入路联合髂窝入路顺行髂坐螺钉治疗累及后柱的 复杂髋臼骨折[J].福建医药杂志,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入路联合髂窝入路顺行髂坐螺钉治疗累及后柱的 复杂髋臼骨折()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
41
期数:
2019年04期
页码:
16-21
栏目:
临床研究
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
文章编号:
1002-2600(2019)04-0016-06
作者:
蔡鸿儒1; 2 林世水1; 2 张旭 鸣1; 2 王玲华 潘 英
福建省立医院急诊外科(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
关键词:
髋臼骨折;  改良Stoppa入路;  髂窝入路;  髂坐螺钉;  后柱
Keywords:
acetabulum fractures;  modified Stoppa approach;  iliac fossa approaches;  antegradeilioschial screws;  posterior column
分类号:
R683.3
文献标志码:
B
摘要:
目的 探讨采用改良Stoppa入路联合髂窝入路顺行髂坐螺钉治疗累及后柱的复杂 髋臼骨折的临床疗效。方法 回顾性分析2014年1月至2017年12月收治的30例复杂髋臼骨折患 者的临床资料。根据手术方式不同将患者分为研究组与对照组。研究组采用改良Stoppa入路 联合髂窝入路,分别于髂耻柱铺设钢板稳定前柱及骨盆内侧植入髂坐螺钉固定后柱骨折。对 照组采用前方改良Stoppa入路联合后方Kocher-Langenbeck入路,分别于髂耻柱铺设钢板稳定 前柱及后方重建钢板固定后柱骨折。比较两组患者的临床疗效。结果 研究组手术时间及术 中出血量均明显少于对照组,差异均有统计学意义(P<0.05)。按改良Matta标准评 定术后骨折复位质量,研究组优良率为 93.33%,对照组优良率为86.67%; 按改良的 Merle d Aubigné和Postel功能评分系统评定术后1年随访时患髋功能,研究组优良率为 93.33%; 对照组优良率为80.00%。以上两个项目患者优良率比较,差异均无统计学意义。术 后并发症发生率比较,差异无统计学意义(P>0.05)。结论 对于累及后柱的复杂髋 臼骨折,改良Stoppa入路联合髂窝入路顺行髂坐螺钉具有手术时间短、术中出血量少、固定 牢靠、损伤小等优点,是一种理想的手术方式。
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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备注/Memo

备注/Memo:
1 福建医科大学省立临床医学院; 2 福建省急诊医学研究所
更新日期/Last Update: 2019-08-15