摘要
目的比较骨盆骨折合并骶髂关节脱位经皮空心螺钉内固定与切开复位重建钢板内固定治疗的临床疗效，并评价其安全性和实用性。方法2004年3月至2010年10月，收治37例不稳定性骨盆骨折。在“C”型臂X线机引导下，20例患者接受经皮骶髂关节螺钉内固定，17例患者接受切开复位重建钢板内固定，比较和分析两组的围手术期参数和术后影像学指标。结果对全部病例随访6-26个月，平均15个月。经皮螺钉组与切开钢板组在手术时间、术中出血量、术后疼痛程度、术后平均发热时间和住院时间等方面比较差异均有统计学意义，两组根据术后X线评价的复位效果差异无统计学意义。骨折平均愈合时间：经皮螺钉组为312个月，切开钢板组为3．6个月，两组差异无统计学意义。经皮螺钉组无感染、弯钉及断钉等并发症发生。结论经皮骶髂空心螺钉内固定术治疗骨盆骨折具有定位准确、损伤小、出血少、疼痛轻、恢复快等优点，是一种理想的微创手术方法，前后环固定适用于骨折及脱位不明显者；该术式对术者操作技术要求较高，充分的术前准备及患者术后配合能减少并发症发生。重建钢板或桡骨远端“T”形钢板可用于固定垂直不稳定性骨盆骨折。
Objective To compare the clinical effect of percutaneous ifiosacral screws osteosynthesis （PISO） and open reduction internal reconstruction plate fixation in treating unstable pelvic fractures combined with sacroiliac joint dislocation, and evaluate their safety and practicality. Methods From March 2004 to October 2010, 37 patients with vertical unstable pelvic fractures were admitted to our department. Twenty cases were treated with percutaneous sacroiliac screw fixation and 17 cases were performed opened reduction and internal reconstruction plate fixation under C-arm X-ray＇s guide. The perioperative parameters and postoperative imaging indexes were compared and analyzed. Results All patients were followed up for 6 months to 26 months, with an average of 15 months. There were statistical significances between the PISO group and open reduction internal fixation group in operation time, blood loss, postoperative pain, mean fever time and hospital stay. The two groups showed no significant difference on postoperative X-evaluation of reduction effect. The average healing time was 3.2 months and the difference was not statistically significant between two groups. PISO group had no complications such as infection, bent nails or broken nails. Conclu- sion Through compared and analyzed the two groups in treating unstable pelvic fractures, the percutaneous sacroiliac screw fixation has been proved for a kind of ideal minimally invasive surgery method because of locating exactly, less damage and blood loss, milder pain and quicker recovery. But it demands higher operation techniques. Adequate preoperative preparation and postoperative patients＇ cooperation can reduce complications incidence. The second group of anterior reconstruction plate or T-shape plate to fix vertically unstable pelvic fractures at same time shows a good result of stabilization.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2011年第11期1191-1196,共6页
Chinese Journal of Orthopaedics
关键词
骨盆
髋骨折
骨折固定术
内
治疗结果
Pelvis
Hip fractures
Fracture fixation, internal
Treatment outcome
