摘要
目的探讨Colorado 2TM骶髂板在治疗Tile C型骨盆骨折中对骶髂关节骨折脱位稳定性重建的作用。方法 2009年2月-2011年1月,收治8例Tile C型骨盆骨折患者。男3例,女5例;年龄22～52岁,平均34.4岁。交通事故伤3例,高处坠落伤3例,重物挤压伤2例。按照Tile分型,C1-2型5例,C1-3型2例,C2型1例。受伤至手术时间5～10 d,平均7 d。经股骨髁上牵引,使骶髂关节骨折脱位复位后,采用Colorado 2TM骶髂板固定骶髂关节,选择性加用骨盆前环重建钢板或外固定支架固定。结果术后X线片复查示骶髂关节垂直和旋转移位均获满意复位,骶髂关节得到有效固定,骨盆后环获得即刻稳定性。术后切口均Ⅰ期愈合,未发生血管、神经损伤等严重并发症。8例均获随访,随访时间6～24个月,平均12个月。骶髂关节无再移位,螺钉无松动。骨折愈合时间6～12个月,平均9个月。末次随访时采用Majeed功能评价标准,获优5例,良2例,一般1例。结论 Colorado 2TM骶髂板固定可使骨盆后环获得有效的即刻稳定性并维持至骨折愈合,是治疗Tile C型骨盆骨折中骶髂关节骨折脱位的有效方法之一。
Objective To explore the effectiveness of Colorado 2TM system in the stability reconstruction of sacroiliac joint fracture and dislocation in Tile C pelvic fracture.Methods Between February 2009 and January 2011,8 cases of Tile C pelvic fracture were treated with Colorado 2TM system.There were 3 males and 5 females with an average age of 34.4 years（range,22-52 years）.Fractures were caused by traffic accident in 3 cases,by falling from height in 3 cases,and by crash of heavy object in 2 cases.According to Tile classification,5 cases were classified as C1-2,2 cases as C1-3,and 1 case as C2.The time between injury and operation was 5-10 days（mean,7 days）.After skeletal traction reduction,Colorado 2TM system was used to fix sacroiliac joint,and reconstruction plate or external fixation was selectively adopted.Results The postoperative X-ray films showed that the reduction of vertical and rotatory dislocation was satisfactory,posterior pelvic ring achieved effective stability.All the incisions healed by first intention,and no blood vessel or nerve injury occurred.Eight patients were followed up 6-24 months（mean,12 months）.No loosening or breakage of internal fixation was observed and no re-dislocation of sacroiliac joint occurred.The bone healing time was 6-12 months（mean,9 months）.According to Majeed’s functional criterion,the results were excellent in 5 cases,good in 2 cases,and fair in 1 case at last follow-up.Conclusion Colorado 2TM system could provide immediate stability of pelvic posterior ring and good maintenance of reduction effect,which is an effective method in the therapy of sacroiliac joint fracture and dislocation in Tile C pelvic fracture.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第12期1426-1429,共4页
Chinese Journal of Reparative and Reconstructive Surgery
