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目的:探讨经前方入路结合阻挡钢板螺钉治疗累及四边体髋臼骨折的临床疗效。方法:采用回顾性病例系列研究分析2017年1月至2019年1月广西医科大学第一、第二附属医院收治的16例累及四边体髋臼骨折患者临床资料,其中男12例,女4例;年龄21~66岁[(45.3±10.6)岁]。按照Letournel-Judet分型:双柱骨折9例,前方+后半横骨折6例,前柱骨折1例。采用髂腹股沟入路9例,腹直肌外侧入路7例,复位骨盆及髋臼骨折,均使用3.5 mm皮质骨全螺纹钉或钢板阻挡四边体骨折块内移。记录切口长度、手术时间、术中出血量。术后第2天,根据Matta影像学标准评价骨折复位情况。根据改良Merle D\'Aubigne-Postel评价标准评估术后3、12个月髋关节功能。观察并发症情况。结果:患者均获随访13~24个月[(16.1±2.9)个月]。髂腹股沟入路手术切口长12~26 cm[(18.6±4.0)cm];腹直肌外侧入路手术切口长8~15 cm[(10.7±2.3)cm]。手术时间107~215 min[(159.2±27.8)min],术中出血量200~2 300 ml[(853.1±489.7)ml]。术后第2天Matta影像学标准评价骨折复位质量:优9例,良7例。术后3个月改良Merle D\'Aubigne-Postel评分为11~18分[(15.2±2.2)分],其中优4例,良7例,可4例,差1例,优良率为69%;术后12个月改良Merle D\'Aubigne-Postel评分为13~18分[(16.9±1.4)分],其中优7例,良8例,可1例,优良率为94%。术后12个月Merle D\'Aubigne-Postel评分高于术后3个月Merle D\'Aubigne-Postel评分(n P<0.05)。切口脂肪液化、膀胱损伤、股外侧皮神经损伤及异位骨化各1例,无内固定物松脱、断裂等并发症。n 结论:经前方入路结合阻挡钢板螺钉治疗累及四边体髋臼骨折,骨折复位满意,可有效防止髋臼四边体骨折移位,术后髋关节功能恢复良好,并发症少。“,”Objective:To investigate the clinical efficacy of anterior approach combined with blocking plates and screws in the management of acetabular fracture involving the quadrilateral area.Methods:A retrospective case series analysis was performed for 16 patients with acetabular fracture involving the quadrilateral area admitted to First and Second Affiliated Hospital of Guangxi Medical University from January 2017 to January 2019. There were 12 males and 4 females,with the age of 21-66 years[(45.3±10.6)years]. According to Letournel-Judet classification,there were 9 patients with bi-column fracture,6 with anterior and posterior traverse fracture and 1 with anterior column fracture. A total of 9 patients were operated via the ilioinguinal approach and 7 via the lateral-rectus approach. Reduction and fixation of the pelvis and acetabulum were performed,using 3.5 mm cortical bone screws or plates to block the internal displacement of fracture in the quadrilateral body. The incision length,operation time and intraoperative blood loss were recorded. The quality of fracture reduction was assessed according to the Matta reduction criteria at postoperative 2 days and hip function by the modified Merle D\'Aubigne-Postel score at postoperative 3 months and 12 months. Postoperative complications were observed.Results:All patients were followed up for 13-24 months[(16.1±2.9)months]. The ilioinguinal approach and lateral-rectus approach showed surgical incision of 12-26 cm[(18.6±4.0)cm]and 8-15 cm[(10.7±2.3)cm],respectively. The operation time was 107-215 minutes[(159.2±27.8)minutes]and the intraoperative blood loss was 200-2,300 ml[(853.1±489.7)ml]. According to Matta reduction criteria,the results were excellent in 9 patients and good in 7. Three months after operation,the modified Merle D\'Aubigne-Postel score was 11-18 points[(15.2±2.2)points],which showed the results were excellent in 4 patients,good in 7,fair in 4 and poor in 1,with the excellent and good rate of 69%. Twelve months after operation,the modified Merle D\'Aubigne-Postel score was 13-18 points[(16.9±1.4)points],which showed the results were excellent in 7 patients,good in 8 and fair in 1,with the excellent and good rate of 94%. The liquefaction of post-surgical incision was seen in a patient,bladder injury in a patient,lateral femoral cutaneous nerve injury in a patient,and heterotopic ossification in a patient. There was no loosening or breakage of the internal fixation.Conclusion:For acetabular fracture involving the quadrilateral area,anterior approach combined with blocking plates and screws can prevent the displacement of quadrilateral fracture and attain satisfactory reductiongood hip function recovery and few complications.