摘要
目的探讨应用Infix结合空心钉治疗中老年合并耻骨联合分离的骨盆损伤的临床疗效。方法回顾性分析2017年1月至2020年12月收治且获得随访的8例中老年合并耻骨联合分离的骨盆损伤患者资料。结果8例患者前环手术时间为40~62 min,平均(46.0±6.2)min,术中出血量25~50 ml,平均(32.0±5.6)ml,髂骨螺钉处切口长度为2.0~3.5 cm,平均(2.6±0.4)cm,空心钉处切口长度为0.8~1.5 cm,平均(1.1±0.3)cm。透视次数为28~52次,平均(36±6)次。术后X片及CT检查提示耻骨联合复位佳,所置入的髂骨螺钉及空心钉均位置良好,切口均愈合良好。Matta放射学标准评定:优7例,良1例,优良率为100%(8/8)。8例患者术后均获得随访,随访时间6~24个月,平均(15.0±4.2)个月。末次随访时行骨盆X线及CT检查,均显示骨折愈合良好,耻骨联合复位未丢失;术后10~12周取出Infix及耻骨联合空心钉,平均(10.5±0.5)周。Majeed骨盆功能评定:优5例,良2例,可1例,优良率为87.5%(7/8)。1例患者术后有股外侧皮神经症状,3个月后自行消失。1例患者术后出现深静脉血栓,予以滤器置入,10周后取出滤器。结论应用Infix结合空心钉治疗中老年合并耻骨联合分离的骨盆损伤,创伤小,术中失血少,固定效果佳,并发症少。
Objective To investigate the clinical effect of Infix combined with hollow screws for the treatment of pelvic injuries with pubic symphysis separation in middle-aged and elderly patients.Methods Data of 8 middle-aged and elderly patients with pelvic injuries due to pubic symphysis separation undergone treatment from January 2017 to December 2020 were retrospectively analyzed.Results The average operating time of 8 patients was(46.0±6.2)min(range:40-62min);the average intraoperative blood loss was(32.0±5.6)ml(range:25-50 ml);the average length of incisions at the iliac screw was(2.6±0.4)cm(range:2.0-3.5 cm);the average length of incisions at the hollow screw was(1.1±0.3)cm(range:0.8-1.5 cm);and the average times of fluoroscopy were(36.0±6.0)times(range:28-52 times).Postoperative X-ray and CT examinations showed that the reduction of the pubic symphysis was good,the inserted iliac screws and cannulated screws were positioned accurately,and the incision healed well.Based on Matta's criteria,postoperative radiological outcomes were evaluated,with 7 cases rated as excellent and 1 as good,giving an excellent to good rate of 100%(8/8).The average followed up time for all 8 patients was(15.0±4.2)months(range:6-24 months).Pelvic X-ray and CT examinations at the last follow-up showed that the fractures healed well and the pubic symphysis reduction did not fail.Infix and cannulated screws in the pubic symphysis were removed 10-12 weeks after surgery[average:(10.5±0.5)weeks].According to the Majeed Pelvic Score,5 cases were rated as excellent,2 cases as good and 1 as fair,with an excellent to good rate of 87.5%(7/8).One patient had symptoms related to the lateral femoral cutaneous nerve that disappeared after 3 months.One patient developed deep venous thrombosis after surgery,and the filter was placed and removed 10 weeks later.Conclusions Using Infix plus cannulated screws for the treatment of pelvic injuries in middle-aged and elderly patients with pubic symphysis separation has the advantages of limited trauma and intraoperative blood loss,good fixation and few complications.
作者
陈同林
郑炫林
王硕磊
文良元
吕先俊
常利民
李涛
朱宝
赵海利
Chen Tonglin;Zheng Xuanlin;Wang Shuolei;Wen Liangyuan;Lv Xianjun;Chang Limin;Li Tao;Zhu Bao;Zhao Haili(Department of Orthopedics and Trauma,Beijing Chaoyang Emergency Rescue Center,Beijing 100122,China;Department of Orthopedics,Beijing Hospital,National Center of Gerontology Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2022年第7期780-784,共5页
Chinese Journal of Geriatrics
基金
北京市朝阳区社会发展科技计划项目(CYSF2035)。
