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目的 探讨髂窝联合Stoppa入路及使用方形区解剖钢板固定治疗髋臼双柱骨折的临床疗效.方法 回顾性分析2015年11月至2017年6月采用髂窝联合Stoppa入路并方形区解剖钢板固定治疗19例髋臼双柱骨折患者资料,男16例,女3例;年龄25~68岁,平均49.11岁;高空坠落伤8例,车祸伤7例,重物砸伤4例.根据Tile分型,C1型11例,C2型7例,C3型1例.Letournel?Judet分型,均为双柱骨折,其中6例合并髋臼后壁移位.所有患者均采用前方髂窝联合Stoppa入路处理骨折块,先经髂窝使用重建钢板将向内上移位的髂耻骨块进行下压固定,再经Stoppa入路使用方形区解剖钢板将内移的坐骨块(方形区骨块)复位固定.术后行X线及CT检查,根据Matta影像学标准评价复位质量;根据Matta改良的Merle d’Aubigné?Postel评分评估髋关节功能.结果 手术时间90~160 min,平均115.26 min;术中出血量300~1 000 ml,平均534.21 ml;切口长度16~20 cm,平均18.82 cm.19例患者均获得随访,随访时间12~28个月,平均19.84个月.术后根据Matta影像学标准评价复位质量,其中解剖复位14例,满意复位3例,不满意复位2例,满意率为89.47%(17/19);所有骨折均愈合良好,骨折愈合时间3~5个月,平均3.32个月.末次随访时,Matta改良的Merle d’Aubigné?Postel评分为13~18分,平均16.95分,其中优12例、良4例、可3例,优良率为84.21%(16/19).术中发生股外侧皮神经损伤1例,闭孔神经损伤1例,均经2个月神经营养治疗联合患侧大腿的功能锻炼获得恢复;髂窝血肿1例,经穿刺抽吸后消失.随访期间无一例发生内固定物松动、断裂或骨块再次移位等并发症.结论 髂窝联合Stoppa入路并方形区解剖钢板固定髋臼双柱骨折可获得满意的临床效果.“,”Objective To explore the clinical outcome an anatomic quadrilateral surface plate for both?column acetabu?lar fractures through the Stoppa combined with iliac fossa approach. Methods A retrospective study of the patients with both?col?umn acetabular fractures treated with an anatomic quadrilateral surface plate through the Stoppa combined with iliac fossa ap?proach from November 2015 to June 2017 was performed. Nineteen patients including 16 males and 3 females met the inclusion criteria. The mean age of included patients was 49.11 years (range, 25-68 years). There were 8 cases of fall injury, 7 cases of car accident injury and 4 cases of crushing injury. There were 11 cases of C1 type injury, 7 cases of C2 type, and 1 case of C3 type ac?cording to Tile classification. Patients included in this study were both?column acetabular fractures according to Letournel?Judet classification. There were six cases associated with posterior wall detachment. Minimally Stoppa combined with iliac fossa ap?proach was performed to manage the displaced fragments. First, the anteromedially displaced iliopubic fragment was managed with a reconstruction plate through iliac fossa approach. Then, the medially displaced ischiadic fragment could be fixed with an anatom?ic quadrilateral surface plate through the Stoppa approach. The reduction quality was assessed by postoperative radiographs and CT scans according to the criteria proposed by Matta. The function of hip joint was assessed by the Merle d’Aubigné?Posteal score modified by Matta. Results The average operation time and blood loss were 115.26 min (range, 90-160 min) and 534.21 ml (range, 300-1000 ml), respectively. The mean length surgical incision was 18.82 cm(range, 16-20 cm). Average follow?up time was 19.84 months (range, 12-28 months). According to Matta criteria of reduction quality, anatomic reduction was obtained in 14 cases, and satisfactory reduction was gained in 3 cases, while unsatisfactory reduction was found in 2 cases (satisfactory rate= 89.47%). All fractures healed well and mean healing time was 3.32 months (range, 3-5 months). The mean Merle d’Aubigné?Post?eal score modified by Matta was 16.95 (range, 13-18), including 12 cases of excellent, 4 cases of good, and 3 cases of fair (satisfac?tory rate=84.21%). Intraoperative injury of lateral femoral cutaneous nerve developed in a case and obturator nerve damage oc?curred in another patient, respectively. Relevant symptoms were totally disappeared after two months’conservative treatment (in?cluding neurotrophic therapy combined with adduction exercise of the affected thigh). Iliac fossa hematoma occurred in a case and relevant symptom was eliminated after puncture. Conclusion Satisfactory clinical outcome of both?column acetabular fractures could be obtained by the anatomic quadrilateral surface plate through the Stoppa combined with iliac fossa approach.