[皮普金骨折中髋臼盂唇损伤的诊断与治疗]

Chen Zhiwei, Liang Xianyong, Wu Junxing, Cui Juncheng, Tang Zhibin, Fan Weijie, Li Chun, Wu Wente, Dai Zhu

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Jan;29(1):14-8.

OBJECTIVE

To observe the characteristics of acetabular labrum injury in Pipkin fractures and the effectiveness of repairing the labrum with suture anchor.

METHODS

Between July 2010 and July 2013, 10 cases of Pipkin fractures accompanied by acetabular labrum injury were treated. There were 7 males and 3 females with an average age of 32.5 years (range, 24-56 years). The causes of injury included traffic accident in 8 cases and falling from height in 2 cases. According to the Pipkin classification criteria, there were 6 cases of type II, 2 cases of type III, and 2 cases of type IV. The average interval from injury to operation was 8 days (range, 6-14 days). All the patients underwent open reduction and internal fixation through transtrochanteric approach with trochanteric osteotomy, and repair the labrum with suture anchor. The effectiveness was evaluated according to the Thompson & Epstein scoring scales after operation.

RESULTS

All incisions healed primarily without early complication of deep infection or deep vein thrombosis of lower limb. All the cases were followed up 22 months on average (range, 12-48 months). X-ray films showed that all osteotomies and acetabular fractures healed within 3-4 months, femoral head and femoral neck fracture healed within 6-11 months. MRI examinations showed that all repaired acetabular labrums well healed. One case had necrosis of the femoral head at 12 months after operation, and was treated by total hip arthroplasty. According to the Thompson & Epstein scoring scales at last follow-up, the results were excellent in 5 cases, good in 3 cases, fair in 1 case and poor in 1 case, with an excellent and good rate of 80%.

CONCLUSION

The diagnosis of acetabular labrum injury can be easily missed during Pipkin fracture, preoperative diagnosis should be combined with hip MRI. Trochanteric osteotomy through transtrochanteric approach , and repairing the labrum with suture anchor can restore the hip function effectively.

目的

观察Pipkin骨折中髋臼盂唇损伤的特点以及使用缝合锚钉修复盂唇的有效性。

方法

2010年7月至2013年7月，治疗10例伴有髋臼盂唇损伤的Pipkin骨折患者。其中男性7例，女性3例，平均年龄32.5岁（范围24 - 56岁）。损伤原因包括交通事故8例，高处坠落2例。根据Pipkin分类标准，Ⅱ型6例，Ⅲ型2例，Ⅳ型2例。受伤至手术的平均间隔时间为8天（范围6 - 14天）。所有患者均采用经转子入路行转子截骨切开复位内固定，并使用缝合锚钉修复盂唇。术后根据Thompson & Epstein评分标准评估疗效。

结果

所有切口均一期愈合，未发生早期深部感染或下肢深静脉血栓形成等并发症。所有病例平均随访22个月（范围12 - 48个月）。X线片显示所有截骨及髋臼骨折在3 - 4个月内愈合，股骨头及股骨颈骨折在6 - 11个月内愈合。MRI检查显示所有修复的髋臼盂唇愈合良好。1例术后12个月出现股骨头坏死，行全髋关节置换术治疗。末次随访时根据Thompson & Epstein评分标准，结果为优5例，良3例，可1例，差1例，优良率为80%。