髋臼冠状面骨折：计算机断层扫描导航下微创经皮固定的前路入路
Coronal acetabular fractures: the anterior approach in computed tomography-navigated minimally invasive percutaneous fixation.
作者信息
Jacob A L, Suhm N, Kaim A, Regazzoni P, Steinbrich W, Messmer P
机构信息
Institute of Diagnostic Radiology, University Hospital of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
出版信息
Cardiovasc Intervent Radiol. 2000 Sep-Oct;23(5):327-31. doi: 10.1007/s002700010061.
PURPOSE
To demonstrate the technical feasibility of the anterior approach to the coronal roof component of carefully selected acetabular fractures in computed tomography (CT)-navigated closed reduction and percutaneous fixation (CRPF).
METHODS
Four patients with nondisplaced or slightly displaced coronal fractures of the acetabular roof were treated with percutaneous screw fixation. Screws were implanted over guidepins placed under CT navigation. Mean clinical and radiological follow-up was 16 months.
RESULTS
All screws could be placed as intended. There were no peri- or postoperative complications. Radiological follow-up showed primary osseous union. Clinical results were excellent according to a median Merle-d'Aubigné score of 18.
CONCLUSION
Nondisplaced or slightly displaced coronally oriented fractures of the acetabular roof can be treated by minimally invasive percutaneous CT-navigated fixation through an anterior approach that does not endanger the sciatic nerve. Early clinical results are encouraging. Close cooperation between trauma surgeons and radiologists and careful selection of cases is mandatory.
目的
证明在计算机断层扫描（CT）引导下的闭合复位和经皮固定（CRPF）中，对精心挑选的髋臼骨折冠状位顶部进行前路手术的技术可行性。
方法
4例髋臼顶部无移位或轻度移位冠状骨折患者接受了经皮螺钉固定治疗。螺钉通过在CT导航下放置的导针植入。平均临床和影像学随访时间为16个月。
结果
所有螺钉均按预期置入。无围手术期或术后并发症。影像学随访显示一期骨愈合。根据Merle-d'Aubigné中位数评分为18，临床结果极佳。
结论
髋臼顶部无移位或轻度移位的冠状位骨折可通过前路微创经皮CT引导固定治疗，该方法不会危及坐骨神经。早期临床结果令人鼓舞。创伤外科医生和放射科医生之间密切合作并仔细选择病例是必不可少的。
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