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[髂窝截骨术治疗合并双柱髋臼骨折的髋关节脱位。改良髂腹股沟入路以避免扩大手术切口]

[Osteotomy of the iliac fossa in the treatment of a hip dislocation associated with a two-column acetabular fracture. Modification of the ilioinguinal approach to avoid an extended surgical approach].

作者信息

Pape H-C, Zelle B, Sitnik J, Gänsslen A, Krettek C

机构信息

Unfallchirurgische Klinik, Medizinische Hochschule, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.

出版信息

Unfallchirurg. 2004 Mar;107(3):239-43. doi: 10.1007/s00113-003-0700-z.

Abstract

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.

摘要

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。

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