Weber T G, Mast J W
Department of Orthopaedic Surgery, Wayne State University School of Medicine, Detroit, MI 48092.
Clin Orthop Relat Res. 1994 Aug(305):106-11.
The surgical approach for exposure of an acetabular fracture is determined by Letournel's fracture classification. Both column fractures typically can be treated through the ilioinguinal approach. If a fracture extends posteriorly to involve the sacroiliac joint or the sciatic buttress, exposure through the ilioinguinal approach can be quite difficult and the extended iliofemoral approach is often recommended. The authors have combined the ilioinguinal and the posterior approach to the sacroiliac joint into one incision termed the extended ilioinguinal approach. Six patients were treated by this approach. The approach allows improved visualization and should prevent some morbidity usually associated with the extended iliofemoral approach. Perfect or near perfect reductions were achieved in all cases. The extended ilioinguinal approach can be useful when treating both column fractures extending posteriorly to involve the sacroiliac joint or the sciatic buttress.
髋臼骨折的手术显露方式由勒图尔内骨折分类法决定。双柱骨折通常可通过髂腹股沟入路进行治疗。如果骨折向后延伸累及骶髂关节或坐骨支,通过髂腹股沟入路进行显露会相当困难,此时常推荐采用扩大髂股入路。作者将髂腹股沟入路与骶髂关节后入路合并为一个切口,称为扩大髂腹股沟入路。6例患者接受了此入路治疗。该入路可改善视野,且应能预防一些通常与扩大髂股入路相关的并发症。所有病例均实现了完美或近乎完美的复位。当治疗向后延伸累及骶髂关节或坐骨支的双柱骨折时,扩大髂腹股沟入路可能会很有用。