单切口配合经皮拉力螺钉与前后联合入路治疗髋臼双柱骨折的比较

摘要

目的：比较两种手术方式治疗髋臼双柱骨折的疗效分析。方法将2008年3月至2014年7月髋臼双柱骨折的患者24例分为甲组（11例）和乙组（13例）。甲组采用单切口配合经皮拉力螺钉治疗，乙组采用前后联合入路。比较两组的手术操作时间、术中出血量、骨折复位matta分级。结果甲组和乙组平均手术时间分别为（106.83±15.29）min、（189.21±11.61）min，术中出血量分别为（642.56±224.85）ml、（938.86±142.56）ml，差异均有统计学意义（P<0.05）。按matta标准评价髋臼骨折复位质量：甲组优良率90.9%，乙组优良率92.8%。髋关节功能参照改良的merled Aubigne标准：甲组优良率87.5%，乙组优良率84%。两组比较差异无统计学意义（P>0.05）。结论单切口配合经皮拉力螺钉和前后联合入路均可以较好的复位和固定髋臼双柱骨折，前者可以明显缩短手术时间，减少术中出血量，是一种良好可行的手术方式。%Objecetive To compare therapeutic effects of two surgical approach in the treatment of fracture of acetabulum double column. Methods From March 2008 to July 2014,24 patients with fracture of acetabulum double column were included in the study. The 24 patients were divided in two groups:group A,treated with single incision with lag screw(11 cases),group B,treated with combined anterior and posterior approach(13 cases). Operation time,intraoperative blood loss and the fracture matta grading were compared in the two groups. Results Statistically significant differences were found in operation time(106.83±15.29 min vs. 189.21±11.61min),intraoperative blood loss(642.56±224.85 vs. 938.86±142.56 ml)in group A and group B(P<0.05). According to Matta’s criteria,group A was 90.9% excellent,good rate of 92.8% in Group B. Hip function reference improved merled Aubigne standards,A was 87.5% excellent,good rate of 84% in Group B,and there was no statistically significant difference in the two groups. Conclusions Both surgical approach can reduction and fixation acetabulum double column fractures,the single incision with lag screw can shorten the operation time,reduce intraoperative blood loss.