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目的:探讨采用改良髂股入路联合有限Pfannenstiel入路治疗复合髋臼骨折的安全性及临床疗效。方法:回顾性分析2017年1月至2018年11月期间南京医科大学第一附属医院创伤骨科采用改良髂股入路联合有限Pfannenstiel入路治疗的43例复合髋臼骨折患者资料。男28例，女15例；年龄为15~78岁，平均48.7岁；骨折按Letournel-Judet分型：T形骨折7例，前方伴后半横形骨折7例，双柱骨折29例。受伤至手术时间为1~20 d，平均7.6 d。所有患者均采用顺行后柱螺钉结合前方钢板固定。记录患者的手术时间、术中出血量、骨折复位质量、患髋功能及术后并发症发生情况等。结果:本组患者的手术时间为90~240 min，平均157.3 min；术中出血量为300~1 500 mL，平均537.2 mL。术后骨折复位质量根据Matta评分标准评定：解剖复位32例，满意复位10例，复位差1例。43例患者术后获9~19个月（平均14.3个月）随访。所有患者骨折均获愈合，愈合时间为10~15周（平均12周）。随访期间无一例患者发生内固定物松动、折断及伤口感染等并发症。末次随访时根据改良Merle d'Aubigne & Postel评分系统评定患髋功能：优12例，良19例，中7例，差5例，优良率为72.1%(31/43)。结论:改良髂股入路联合有限Pfannenstiel入路治疗复合髋臼骨折可以获得良好复位，具有术中出血量少、手术时间短、创伤小等优点，疗效相对满意。“,”Objective:To investigate the safety and clinical efficacy of a combination of modified iliofemoral approach and limited Pfannenstiel approach for the treatment of complex acetabular fractures.Methods:A retrospective study was conducted of the 43 patients with complex acetabular fracture who had been treated by a combination of modified iliofemoral approach and limited Pfannenstiel approach from January 2017 to November 2018 at Department of Orthopaedics and Trauma, The First Affiliated Hospital to Nanjing Medical University. They were 28 males and 15 females, aged from 15 to 78 years (average, 48.7 years). By the Letournel-Judet classification, there were 7 T-shaped fractures, 7 anterior column plus posterior transverse fractures, and 29 both column fractures. The time from injury to operation ranged from 1 to 20 days, averaging 7.6 days. All fractures were fixed with anterograde posterior screws and an anterior plate. Recorded were operation time, intraoperative blood loss, reduction quality, functional recovery of the affected hip and postoperative complications.Results:The operation time ranged from 90 to 240 min, averaging 157.3 min; the intraoperative blood loss ranged from 300 to 1,500 mL, averaging 537.2 mL. By the Matta criteria, anatomical reduction was achieved in 32 patients, satisfactory reduction in 10 patients and poor reduction in one patient. The 43 patients were followed up for 9 to 19 months (average, 14.3 months) postoperatively. All fractures healed after 10 to 15 weeks (average, 12 weeks), with no complications like loosening or breakage of internal fixation or wound infection. According to the modified Merle d'Aubigne & Postel scoring at the last follow-up, the function of affected hip was evaluated as excellent in 12 cases, as good in 19, as fair in 7 and as poor in 5, giving an excellent and good rate of 72.1% (31/43).Conclusion:For the treatment of complex acetabular fractures, the modified iliofemoral approach combined with limited Pfannenstiel approach can achieve good reduction and significantly less intraoperative blood loss and operation time, and reduce surgical trauma and risk, leading to satisfactory therapeutic efficacy.