摘要
目的研究复杂C3型骨盆骨折内固定的手术策略及临床疗效。方法2016年12月至2018年5月收治的复杂C3型骨盆骨折患者43例,先行骨牵引,以锁定钢板或微创螺钉内固定,再采用有限切开复位内固定手术进行治疗。记录手术时间、术中出血量、住院时间等指标;记录手术并发症;末次随访时,采用改良的Mere d'Aubigne-Postel髋关节评分标准和Matta髋臼骨折复位标准评估手术效果。结果所有患者手术成功,手术时间180~300 min,平均(236.52±49.62)min;术中出血量200~600 mL,平均(318.23±87.24)mL;住院时间14~19 d,平均(16.81±2.17)d。全部患者术后随访12~24个月,平均(15.81±3.12)个月,末次随访时,骨盆骨折均愈合良好,愈合时间9~15周,平均时间(12.12±2.15)周。依据改良的Mere d'Aubigne和Postel髋关节评分标准,优29例、良11例、一般3例,优良率93.02%;依据Matta髋臼骨折复位标准,优32例、良7例、差4例,优良率90.70%。本组中有2例患者术后3个月负重行走时出现疼痛症状。结论对复杂C3型骨盆骨折,先采取术前骨牵引等稳定骨盆骨折,再选择适当髋臼入路有限切开复位内固定手术,可取得满意效果,具有创伤小、恢复快的特点,值得临床推广。
Objective To explore the surgical strategy and clinical effect of internal fixation for complex C3 pelvic fractures.Methods Patients with complex C3 pelvic fractures admitted from December 2016 to May 2018 were studied.Bone traction was used for locking plate or minimally invasive screw internal fixation,followed by limited open reduction and internal fixation.Surgical indicators such as operation time,blood loss and hospitalization time were recorded,and surgical complications were recorded.At the last follow-up,the improved Mere d'aubigne-Postel hip score criteria and Matta acetabular fracture reduction criteria were used to evaluate the clinical effect.Results All patients were successfully operated,and the operative time was 180-300 min,with an average of(236.52±49.62)min.The intraoperative blood loss was 200-600 ml,with an average of(318.23±87.24)ml.The hospital stay was 14-19 d,and the average hospital stay was(16.81±2.17)d.The follow-up time was 12-24 months,mean(15.81±3.12)months.At the last follow-up,all pelvic fractures healed well,and the healing time was 9-15 weeks,with an average time of(12.12±2.15)weeks.According to the modified grading criteria of hip joint of Mere d'aubigne and Postel,29 cases were excellent,11 cases were good,and 3 cases were general,with an excellent and good rate of 93.02%.According to Matta criteria for reduction of acetabular fractures,32 cases were excellent,7 cases were good,4 cases were poor,and the excellent and good rate was 90.70%.Two patients presented pain symptoms during weight-bearing walking 3 months after surgery.Conclusion For complex C3 pelvic fractures,preoperative bone traction and other stable pelvic fractures,followed by appropriate acetabular approach limited open reduction and internal fixation,can achieve satisfactory result.It has the characteristics of small trauma and rapid recovery,and is worthy of clinical promotion.
作者
马泽涛
王德利
翁鉴
冯松
MA Zetao;WANG Deli;WENG Jian;FENG Song(Department of Bone and Joint,Peking University Shenzhen Hospital,Shenzhen 518036,China)
出处
《组织工程与重建外科》
2021年第3期247-250,共4页
Journal of Tissue Engineering and Reconstructive Surgery
关键词
骨盆骨折
C3型
微创螺钉内固定
切开复位
Pelvic fracture
C3 type
Minimally invasive screw internal fixation
Open reduction
