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-  2015 

Pipkin骨折中髋臼盂唇损伤的诊断及治疗

DOI: doi:10.7507/1002-1892.20150004

Keywords: Pipkin骨折, 髋臼盂唇损伤, 大转子截骨, 带线锚钉

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Abstract:

目的总结Pipkin骨折中髋臼盂唇损伤的特点及采用带线锚钉修复的临床疗效。 方法2010年7月—2013年7月,收治Pipkin骨折合并髋臼盂唇损伤患者10例。其中男7例,女3例;年龄24~56岁,平均32.5岁。致伤原因:交通事故伤8例,高处坠落伤2例。根据Pipkin骨折分型:Ⅱ型6例,Ⅲ型2例,Ⅳ型2例。受伤至手术时间为6~14 d,平均8 d。采用经转子入路大转子截骨治疗Pipkin骨折、带线锚钉修复髋臼盂唇。术后参照Thompson及Epstein临床和影像学评定标准评价其临床疗效。 结果术后切口均Ⅰ期愈合,无深部感染、下肢深静脉血栓形成等早期并发症发生。10例患者均获随访,随访时间12~48个月,平均22个月。X线片复查示大转子截骨、髋臼骨折愈合时间为3~4个月,股骨颈、股骨头骨折愈合时间为6~11个月。MRI复查示髋臼盂唇均愈合良好。1例患者术后12个月出现股骨头缺血性坏死,行人工全髋关节置换术。末次随访时,按Thompson及Epstein临床和影像学评定标准,获优5例,良3例,中1例,差1例,优良率80%。 结论Pipkin骨折中髋臼盂唇损伤易漏诊,术前需结合髋关节MRI辅助诊断。采用经转子入路大转子截骨治疗Pipkin骨折、带线锚钉修复髋臼盂唇,能有效恢复髋关节功能,疗效满意

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