The Effect Of Operation And Complication Analysis For Fractures Of The Acetabulum With Posterior Dislocation Of The Hip

ObjectiveTo evaluate the treatment results and its complication reason of acetabular fractures ofsurgical treatment for cases of acetabulum fractures with dislocation after hip joint byretrospective analysis in order to reduce the incidence of the complications and improvethe clinical efficacy.MethodsAccording to the inclusion criteria and exclusion criteria from January2000to June2000in jinan military region general hospital and because of acetabulum bone fracturewith cases of hip dislocation after selecting the object of study.All patients preoperative are filming with pelvic X-ray plain film, pelvic CT andthree-dimensional reconstruction. One: For hip dislocation reduction and we are the mostcommonly used methods for Allis method, also known as pulling method. To call for tablettrauma patients lie on your back or on the ground, a doctor at a fixed pelvic with hands,another doctor stand opposite to patients, The patients with hip and knee buckling in the90°, or forearm with both hands hold the patient’s Yan home location, continuous traction it,support the popliteal fossa on gauze. After a period of time, and being thigh muscle inpatients with muscle relaxation, to do the hip outward turning action.This dislocation ofhip joint can be reset. Reset the doctor could feel hip with bounce and noise. If there is adislocation of hip joint failed to manual reduction, under the condition of the patientgeneral condition allows, line of open reduction surgery as soon as possible.two: Foracetabulum fractures associated with dislocation after hip surgery, we usually adopt K-Linto the road. Notch up after iliac spine. After also can be made of iliac spines on belowtwo horizontal refers to starting. After an arc continue outward. When they arrived in largefemoral trochanter, we should trailing in its shares into longitudinal line going down. Stepby step a skin incision, blunt separation muscles and other soft tissues, fully reveal acetabulum fracture and dislocation of femoral head, reset the emergence of theacetabulum and femoral head fracture end. Reconstruction plate and3.5mm screws wereused to fix the reduced fractures.Three: Look carefully after surgery. Follow-up of patientsdischarged from hospital on a regular basis, including: The complaints of the patient,Clinical medical and Check pelvic X-ray plain film. Four: evaluation of therapeutic effects:Matta standard for evaluation of fracture the situation. Evaluation of hip joint is functionMerled Aubighe ’and Postel hip scoring criteria. MCRR standards are evaluating sciaticnerve functional recovery.ResultsThis study is according to inclusion criteria and exclusion criteria. Collected85casesfrom jinan military region general hospital. Longest time minimum follow-up of7.6years,10.9years, average5.9years. With reference to Matta standard evaluation of fracture:anatomical reduction in23cases, satisfactorily reduction in43cases, not satisfactorilyreduction in19cases. Use the reference of Merled ’Aubighe and Postel hip to scoringcriteria evaluation. the degree of pain. results: excellent in26cases, good in34cases, fairin20cases and poor in5cases.A total of17patients were sciatic nerve injury preoperatively. postoperativefunctional recovery was evaluated by the MCRR functional, which include two aspects:the Muscle strength and sensation. The results were as follows: excellent and good in12cases, fair and poor in5cases. A few postoperative were found: eleven cases of avascularnecrosis, three cases of traumatic arthritis and one case of heterotopic ossification.ConclusionsOne: Surgery part of acetabulum fractures associated with dislocation after hip jointcan be achieved with good results. Two: The fracture types,hip dislocation reset time,operation opportunity and the quality of the reset are affect the acetabulum fracturesassociated with dislocation after hip surgery effect of the key factors. Three：Hipdislocation reset as soon as possible,timely surgery, intraoperative protection of bloodvessels and nerves and high quality of the reset can may reduce postoperative ischemicnecrosis of femoral head and to improve curative effect of operation. Four: Hip dislocationreset as soon as possible, timely surgery, intraoperative protection of blood vessels andnerves and high quality of the reset can promote the recovery of sciatic nerve function andimprove the surgical curative effect.