| 前外侧入路治疗PipkinⅠ、Ⅱ髋关节骨折的探讨 |
|
摘要点击次数: 127
全文下载次数: 0
投稿时间：2018-01-03 修订日期：2018-05-30
|
|
|
| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
| DOI： |
| 基金项目: |
|
| 中文摘要:【】 目的 探讨髋关节前外侧入路(McFarland及Osborne入路)可吸收螺钉内固定治疗PipkinⅠ、Ⅱ 型骨折临床疗效。 方法 本研究回顾性分析我科2008年3月至2016年2月采用髋关节前外侧入路(McFarland及Osborne入路)可吸收螺钉固定治疗8例Pipkin Ⅰ、Ⅱ 型骨折患者资料男5例,女3例；年龄23~58岁,平均36岁；损伤侧别：左髋3例,右髋5例,Pipkin骨折分型：I型2例,II型6例。所有患者均急诊在静脉复合麻醉下行髋关节后脱位手法整复复位(Allis法),复位成功后给予骨牵引,受伤至手术时间平均为5d(3~12d)。手术采用McFarland及Osborne入路,完全保护好臀中肌、部分切开臀小肌,纵行或辅以小横形即‘T’形切口切开关节囊处理股骨头骨折。 结果 所有患者手术时间为1~4h,平均2.5h,术中出血量为100ml~400ml,平均200ml。所有患者术后手术切口一期愈合,无切口感染。术后x线片及CT三维重建检查股骨头复位良好。8例患者获得6~24月,平均16月随访,所有患者骨折均愈合,愈合时间为3.0~6.0月,平均4.0月. 1例发生创伤性关节炎,无股骨头缺血性坏死及异位骨化发生。根据Thompson-Epstein评分系统评定髋关节功能：优5例,良2例,可1例,优良率为87.5% 结论 髋关节前外侧入路既能够保护好股骨头残存血供、又能够充分显露髋臼和股骨头,是治疗PipkinⅠ、Ⅱ型骨折较理想的手术入路选择。 |
| 【关键词】髋脱位 股骨头 骨折 手术入路 |
| |
| The research of the treatment for Pipkin I and II hip fractures by anterolateral approachTaizhou municipalShospital Trauma, joint surgery; |
|
| ABSTRACT Objective The objective is to investigate the clinical effect of absorbable screw fixation by anterolateral approach (McFarland and Osborne approach) in the treatment of Pipkin type I and type II fractures .Methods We retrospectively analyzed 8 cases of Pipkin type I &II fractures treated by absorbable screw fixation by anterolateral approach (McFarland and Osborne approach) from March 2008 to February 2016 in our department .There were 5 males and 3 females, aged 23~58 years, with an average age of 36 years. The injury sides included 3 cases of left hip, 5 cases of right hip, and 2 cases of Pipkin type I and 6 cases of Pipkin type II.All patients received emergency reduction (Allis) of the posterior dislocation of the hip under the combined intravenous anesthesia. Bone traction was performed after successful reduction, and the average time from the injury to operation was 5D (3~12d).The operation by using McFarland and Osborne approach,Completely?protect the gluteal muscle, cut part of the gluteus minimus, longitudinal or small transverse form is supplemented by the ‘T'' shaped incision capsulotomy to treat femoral head fracture. Results The operation time of all patients was between 1 to 4h, with an average of 2.5h, and the intraoperative blood loss was between 100ml to 400ml, with an average of 200mL.All the patients had primary healing after operation without incision infection.The postoperative X-ray and CT 3D reconstruction showed good reduction of the femoral head.8 patients were followed up for 6~24 months, with an average of 16 months follow-up. All fractures consolidated, and the healing time was 3.0~6.0 months, with an average of 4 months.Traumatic arthritis occurred in 1 case, no avascular necrosis of the femoral head and heterotopic ossification occurred,according to Thompson-Epstein scoring system, hip function was excellent in 5 cases, good in 2 cases and fair in 1 cases, with an excellent and good rate of 87.5%. Conclusion The anterolateral approach of hip joint can not only protect the residual blood supply of femoral head, but also fully expose the acetabulum and femoral head. It is a relatively ideal surgical approach for the treatment of Pipkin type I and type II fractures. |
| KEY WORDS Hip dislocation Femoral head Fracture operative approach |
| |
| 引用本文，请按以下格式著录参考文献： |
|
|
| 阅读全文 下载 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
