下腹正中切口入路治疗骨盆髋臼骨折

摘要

目的 探讨下腹正中切口入路(改良Stoppa入路)治疗骨盆髋臼骨折的手术方法和临床效果.方法 2008年1月至2012年7月采用改良Stoppa入路切开复位内固定法治疗骨盆髋臼骨折患者24例,其中男22例,女2例,年龄22 ～50岁.骨折均应用单独或联合重建钢板固定.结果 所有骨折达到解剖或满意复位,皮肤切口长度8～13 cm,平均(10.0±1.6)cm；手术时间60 ～ 120 min,平均(80±15) min；出血量300 ～ 1000 ml平均出血(600±136)ml.伤口均甲级愈合,随访时间2～ 48个月,无手术并发症,功能结果均满意,所有患者家庭生活满意.结论 改良的Stoppa入路切开复位内固定治疗骨盆髋臼骨折,术后可以获得良好的放射学及临床结果,并发症少.%Objective To evaluate operative method and outcome through a low midline incision(modified Stoppa) approach in treatment of pelvic and acetabular fractures.Methods All 24 consecutive patients with pelvic or acetabular fracture who were treated with modified Stoppa approach for pelvic or acetabular fracture fixation From Feburary 2008 to March 2012 were retrospectively analyzed.Ten patients were with a pelvic ring injury not involving the acetabular joint and eight patients with a combined fracture,two patients with acetabular fractures were fixed with reconstruction plate.Results Anatomic or satisfactory reduction was achieved in all fractures.The average incision length of the Stoppa was (10.0 ± 1.6) cm (8 to 13 cm),the mean operation time and blood loss were (80 ±15)min (60 to 120 min)and (600 ± 136)ml (300 to 1000 ml) respectively.All cases were followed up 3 to 48months showing satisfactory functional results and no operative complications.All patients satisfied with family life.Conclusions Open reduction and internal fixation of plvic and acetabular fractures through the modified Stoppa approach may have good postoperative radiological and clinical outcomes and have less complications.This is a method of choice for patients with combined trauma with internal organ damage and patients with both side pelvic bone fracture.