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[关节镜辅助下髋臼后柱骨折的固定]

[Fixation of acetabulum posterior column fracture, arthroscopy assisted].

作者信息

Altamirano-Cruz M A, Flores-Villalobos A, Rodríguez-Lara S Q, Bustos-Mora R, Gutiérrez-Ramírez L X

机构信息

Departamento de traumatología y ortopedia. Módulo de politrauma, pelvis y acetábulo. Unidad Médica de Alta Especialidad, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social. Guadalajara, Jalisco, México.

Unidad Médica de Alta Especialidad, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social. Guadalajara, Jalisco, México.

出版信息

Acta Ortop Mex. 2020 Jul-Aug;34(4):222-227.

Abstract

Arthroscopic surgery of the hip has evolved significantly over the last years, offering an opportunity of treatment in several intra-articular pathologies. Recent methods and instrumental advances have allowed more frequent use of this procedure, with various indications such as: hip pain, acetabular labrum lesions, extraction of foreign bodies, debridement in septic arthritis, pincer impingement, and some extra-articular injuries. Another intra-articular hip pathology that benefits from arthroscopic assistance could be found in the management of simple acetabular fractures. Therefore, this report presents the case of a patient with a posterior column fracture treated with an arthroscopic approach. Arthroscopic techniques for the fixation of intra-articular fractures offer the advantage of a direct visualization of the articular surface, which results in an anatomical reduction. In addition, arthroscopic techniques also present a benefit for intra-articular injuries such as the posterior labral lesion in this case. In simple fractures of the posterior acetabular column with minimum displacement, where percutaneous screw fixation is useful as a definitive fixation method, hip arthroscopy is useful for the reduction process and verifies the extra-articular screw trajectory.

摘要

在过去几年中,髋关节镜手术有了显著发展,为多种关节内病变提供了治疗机会。近期的方法和器械进展使得该手术的应用更为频繁,其适应证包括:髋关节疼痛、髋臼盂唇损伤、异物取出、化脓性关节炎清创、钳夹撞击征以及一些关节外损伤。在单纯髋臼骨折的处理中也能发现另一种受益于关节镜辅助的关节内髋关节病变。因此,本报告介绍了一例采用关节镜方法治疗后柱骨折患者的病例。关节镜技术用于关节内骨折固定的优势在于可直接观察关节面,从而实现解剖复位。此外,关节镜技术对于此类病例中的关节内损伤(如后方盂唇损伤)也有帮助。在单纯髋臼后柱骨折且移位最小的情况下,经皮螺钉固定作为一种确定性固定方法是有效的,髋关节镜则有助于复位过程并验证关节外螺钉的轨迹。

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