Résumé
Objective To investigate the clinical effect of surgical treatment of acetabular fractures. Methods From June 1995 to December 2000, 62 cases of acetabular fracture with dislocation were treated with open reduction and internal fixation. There were 13 cases with fractures of the posterior wall, two with posterior column fractures, three with anterior column fractures, five with transverse fractures, 15 with transverse and posterior wall fractures, three with posterior column and wall fractures, five with T-shaped fractures, four with anterior and hemi-transverse fractures and 12 with fractures of both column. Kocher-Langenbeck (K-L) approach was applied in 37 cases, ilioinguinal approach in 12, extended iliofemoral approach in four, iliofemoral approach in two, and combined approaches (K-L+ilio-inguinal) in seven. Results Anatomic reduction was done in 37 cases, with satisfactory results in 17 and unsatisfactory results in eight. Reduction for joint vallatae was performed in four cases. The follow-up was 1-5 years (average 2.7 years). The total excellence rate of clinical results was 71% (44/62), with excellence rate in anatomic and non-anatomic reduction groups for 89% (33/37) and 44% (11/25), respectively, with a very significant difference (?2=22.89, P
Résumé
Objective To evaluate the application of cervical lateral mass plate fixation in the treatment of fracture and dislocation of lower cervical spine. Methods From February 2001 to June 2003, 21 cases of lower cervical spine injury were treated by cervical lateral mass plating fixation, received spinal decompression and reduction according to the types of fracture and dislocation. A cervical lateral mass plate was applied in each lateral mass. The screw prick point was defined at 1-2 mm inner and lower to the mass center. The sagital angle, horizontal angle of internal fixation screw were 45 degrees and 25-30 degree respectively. Results The follow up ranged from nine months to two years and nine months (mean 13 months). All cases were encouraged to sit up, wearing soft collar 4-7 days after the surgery. The mean off-bed time of those cases without spinal cord injuries less than Frankel C grade were seven days (4-14 days) after operation. All cases obtained solid bony fusion 4-6 months postoperatively. Sixteen cases with spinal cord injury improved for one grade according to American Spinal Injury Association. Three cases with nerve root injury obtained complete recovery after operation. There was no severe complication such as vertebral artery nerve root or spinal cord injuries or aggravation of spinal cord injury. One case had uneven reduction and two suffered screw loosening. Conclusion Cervical lateral mass plate fixation is an efficient and reliable technique for segmental posterior fixation, for it has the advantages of wide indication, relatively simple and safe operating as well as strong stability.