Pape H-C, Zelle B, Sitnik J, Gänsslen A, Krettek C
Unfallchirurgische Klinik, Medizinische Hochschule, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Unfallchirurg. 2004 Mar;107(3):239-43. doi: 10.1007/s00113-003-0700-z.
Open reduction and internal fixation is the treatment of choice for displaced acetabular fractures. The surgical approach depends on the fracture type, concomitant injuries, and general condition of the patient. The ilioinguinal approach provides a good exposure to the medial wall and is associated with an acceptable degree of surgical trauma. Exposure of the joint surface, however, is difficult when using the ilioinguinal approach. We report a case of a polytraumatized 39-year-old patient who sustained a posterior hip displacement and a two-column acetabular fracture. An osteotomy of the iliac ala was performed via an ilioinguinal approach to fragments of the acetabular surface that were displaced distally. Thereby, reposition of a craniolateral fragment was achieved without the need to extend the surgical approach or to perform a second incision.
切开复位内固定是移位髋臼骨折的首选治疗方法。手术入路取决于骨折类型、合并伤以及患者的一般状况。髂腹股沟入路能很好地显露内侧壁，且手术创伤程度可接受。然而，采用髂腹股沟入路时，关节面的显露较为困难。我们报告一例39岁多发伤患者，其发生了髋关节后脱位及双柱髋臼骨折。通过髂腹股沟入路对髋臼表面向远侧移位的骨折块进行了髂骨翼截骨术。从而在无需扩大手术入路或进行二次切口的情况下实现了颅外侧骨折块的复位。
