摘要目的 探讨计算机导航辅助下对髋臼骨折采用经皮或有限切开复位微创治疗的疗效.方法 2006年6月至2009年10月对17例髋臼骨折患者根据骨折类型和患者一般情况采取闭合或有限切开复位,髋臼前后柱螺钉固定.其中男12例,女5例;年龄19～66岁,平均45.6岁.所有固定柱的空心螺钉均在导航系统指导下置入.术后第2天开始下肢功能锻炼.计算平均置入1枚髋臼前后柱螺钉所需时间、透视次数及新鲜髋臼骨折手术出血量. 结果 本组患者共置入29枚螺钉,平均置入1枚螺钉所需时间为34min,透视次数为29次.新鲜骨折中示切开复位患者出血量低于50 mL,有限切开复位患者出血量平均为350 mL.所有患者术后随访6～60个月,平均30个月.按照Matta功能评分平均为16.1分,优良率为82.4％.按照Matta放射评分优良率为941％.无神经、血管损伤并发症发生. 结论 计算机导航辅助下对髋臼骨折实施闭合复位或者有限切开复位,空心螺钉固定的微创治疗,疗效满意,同时大大减少手术相关并发症.

abstractsObjective To explore the effcacy of minimally invasive treatment of acetabular fractures assisted by image-based computer guidance system Methods From June 2006 to October 2009,closed or limited open reduction and screw fixation of the anterior and posterior acetabular columns were performed in 17 cases of acetabular fracture depending on their fracture type and general condition.They were 12 men and 5 women,aged from 19 to 66 years (average,45.6 years).All cannulated screws were inserted under the guidance of image-based computer navigation system Rehabilitation program started on day 2 postoperation Time for each screw inseaion,radiation exposure and intraoperative blood loss were documented. Results In this series,altogether 29 screws were inseaed.On average eacn insertion required 34 minutes and 29 radiation exposures The mean intraoperative blood loss was less than 50 mL for patients undergoing closed reduetion and 350 mL for patients undergoing limited open reduetion All the patients were followed for an average of 30 months (from 6 to 60 months).By Matta system,this series had a mean functional score of 16.1,a good to excellent function rate of 82.4％ and a good to excellent radiological rate of 94.1％.Conclsion In treatment of acetabular fractures,percutaneous or limited open reduction aided by computer navigation system can largely reduce complications and radiation exposure and thus improve clinical efficacy.