经皮骶髂关节螺钉治疗骶骨纵形骨折  

Percutaneous iliosacral screws fixation for the vertical fractures of the sacrum

作　　者：孔建中[1] 郭晓山[1] 潘骏[1] 黄俊武[1] 杨雷[1] 彭茂修[1] 陈龙[1] 翁益民[1] 

机构地区：[1]温州医学院附属第二医院骨科,325027

出　　处：《中华创伤杂志》2005年第6期410-412,共3页Chinese Journal of Trauma

摘　　要：目的应用经皮骶髂关节螺钉固定术治疗骶骨纵形骨折及疗效评价。方法牵引复位后,C形臂X线机透视下经皮骶髂关节螺钉固定骶骨纵形骨折19例,男11例,女8例;年龄18～57岁,平均30.2岁。其中17例行骨盆前环固定,闭合复位耻骨支经皮空心拉力螺钉固定9例,耻骨联合分离经皮拉力螺钉固定2例,耻骨支骨折合并耻骨联合分离经皮拉力螺钉固定1例,耻骨支切开复位钢板螺钉固定5例。结果手术时间30～65min,平均42.5min。术后住院时间3～12d,平均6.5d。19例均获得随访,时间6～34个月,平均18.5个月。无骶髂部疼痛16例,轻度疼痛3例;18例均恢复原工作,1例术后再移位行切开复位内固定术而发生医源性S1神经损伤。结论经皮骶髂关节螺钉固定骶骨纵形骨折是一种安全、有效的治疗方法,手术创伤小,并发症少,手术时间短,康复快。Objective To introduce percutaneous iliosacral screws fixation for treatment of the vertical fractures of the sacrum and evaluate the preliminary clinical outcomes. Methods A total of 19 cases (11 males and 8 females) with vertical fractures of the sacrum were treated with percutaneous iliosacral screws fixation under the “C” arm fluoroscopic guidance. The age ranged from 18 to 57 years, mean 30.2 years. Of all, 17 cases were treated with anterior pelvis fixation, nine with closed reduction with percutaneous pubic ramus screw fixation, two (with separation of symphysis pubis) with percutaneous screw fixation, one (with separation of symphysis pubis and fracture of pubic rami) with a closed reduction plus percutaneous screw fixation, and five with open reduction plus plate internal fixation. Results The operation lasted for 30-65 minutes (average 42.5 minutes) and hospitalization period ranged from 3 to 12 days (average 6.5 days). A follow up for 6-34 months (average 18.5 months) in all patients showed that 16 case were free from sacroiliac pain, three had a slight pain and 18 returned to work but one case with failed fixation received open reduction internal fixation but had a complication of iatrogenic S 1 nerve root injury. Conclusions The percutaneous iliosacral screw fixation is an ideally safe and effective operation for vertical fractures of the sacrum and has the advantages of minor trauma, less complication, short operation time and quick recovery.

关 键 词：骶骨纵形骨折 关节螺钉 经皮 拉力螺钉固定 切开复位内固定术 耻骨联合分离 钢板螺钉固定 骶髂关节 固定术治疗 X线机透视 骶髂部疼痛 耻骨支 疗效评价 闭合复位 手术时间 神经损伤 治疗方法 手术创伤 平均 复位后 C形臂 

分 类 号：R687.3[医药卫生—骨科学]