论文部分内容阅读
目的:比较直接后方入路（DPA）与Kocher-Langenbeck(K-L)入路治疗髋臼后部骨折的临床疗效。方法:回顾性分析2012年1月至2018年6月期间南方医科大学第三附属医院创伤骨科收治的45例髋臼后部骨折患者资料。根据手术入路不同分为两组：A组21例，男17例，女4例；年龄为（42.2±14.7）岁；采用DPA钢板固定治疗。B组24例，男21例，女3例；年龄为（42.8±11.9）岁；采用K-L入路钢板固定治疗。比较两组患者的手术时间、术中出血量、手术切口长度、骨折愈合时间、骨折复位质量、术后并发症发生情况及末次随访时患髋功能等。结果:两组患者术前一般资料比较差异均无统计学意义（n P>0.05），具有可比性。A组患者的手术时间[（60.0±15.7）min]、手术切口长度[（9.6±1.1）cm]显著短于B组患者[(115.2±42.4) min、（17.6±2.3）cm]，术中出血量[(325.7±79.9) mL]显著少于B组患者[(404.2±147.4) mL]，差异均有统计学意义(n P0.05)。末次随访时根据改良Merle d'Aubigne & Postel评分系统评定患髋功能：A组优14例，良5例，可2例，优良率为90.5%(19/21)；B组优12例，良3例，可6例，差3例，优良率为62.5%(15/24)，差异有统计学意义(n P0.05). Group A had significantly shorter operation time (60.0 min ± 15.7 min), significantly shorter incision length (9.6 cm ± 1.1 cm) and significantly less intraoperative blood loss (325.7 mL ± 79.9 mL) than group B (115.2 min ± 42.4 min, 17.6 cm ± 2.3 cm and 404.2 mL ± 147.4 mL, respectively) (n P0.05).The functional recovery of the affected hip by the modified Merle d'Aubigne-Postel scoring system at the last follow-up was rated as excellent in 14 cases, good in 5 and fair in 2, giving an overall excellent and good rate of 90.5%(19/21) in group A while as excellent in 12 cases, good in 3, fair in 6 and poor in 3, giving an excellent and good rate of 62.5%(15/24) in group B, showing a significant difference between the 2 groups (n P<0.05).n Conclusions:In the treatment of posterior acetabular fractures, the direct posterior approach is safe and effective because it is advantageous over the conventional K-L approach in operation time, intraoperative blood loss, surgical invasion and postoperative recovery.