不稳定性骨盆骨折的内固定治疗  

Surgical treatment of unstable pelvic fractures with internal fixation

作　　者：肖玉周[1] 周建生[1] 张长春[1] 官建中[1] 刘振华[1] 刘泉[1] 周新社[1] 

机构地区：[1]蚌埠医学院附属医院骨科,安徽蚌埠233004

出　　处：《中国骨伤》2007年第9期616-618,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨不稳定性骨盆骨折手术治疗的临床疗效。方法:自2000年5月至2006年3月手术内固定治疗不稳定性骨盆骨折39例,男25例,女14例;年龄16～61岁,平均38.6岁。根据Tile分型,B1型8例,B2型16例,B3型5例,C1型7例,C2型3例。B型和部分C1型骨折,采用耻骨联合上方弧形切口或经髂腹股沟入路,应用钛合金重建钢板内固定。C1型骨折,主要采用闭合复位,经皮骶髂拉力螺钉内因定。C2型骨折,采用闭合复位,经皮骶髂拉力螺钉内固定,再前方入路内固定。结果:术后随访时间2～68个月,平均18.6个月,骨折愈合时间平均2.4个月。术后并发症:切口感染1例,创伤性湿肺1例,神经牵拉伤1例,均治愈,无死亡病例。按Mears术后影像评定标准:解剖复位31例,复位满意7例,复位不满意1例。按照Majeed的疗效评定标准:优32例,良7例。结论:不稳定性骨盆骨折采用手术内固定,可以有效恢复骨盆的稳定性,远期疗效好,极大地降低其致残率。Objective：To explore the therapeutic effects and surgical treatment for unstable pelvic fractures with internal fixation. Methods：From May 2000 to March 2006,39 patients with unstable pelvic fractures were treated with open reduction and intermal fixation. There were 25 males and 14 females aging from 16 to 61 years （ mean ,38.6 years）. According to Tile＇s clas- sification,Type B1 fracture was diagnosed in 8 patients,type B2 in 16 patients, type B3 in 5 patients, type C1 in 7 patients,type C2 in 3 patients. The fractures of type B and part of type C1 were internally fixed with pelvic-reconstruction plate made of tita- nium-alloy through pfannenstiel incision or ilioinguinal approach. Closed reduction and percutaneous iliosacral screws were used for type C1 fracture. Closed reduction and percutaneous iliosacral screws combimed with internal fixation through anterior ap- proach were used for type C2 fracture. Results：All the patients were followed up on an average of 18.6 months （range,2 to 68 months）. The healing time of fractures were within an average of 2.4 months. The postoperative complications included ：wound infection in 1, traumatic wet lung in 1, traction injury of the nerve in 1. All the complications were cured, and no case of death. According to Mears＇s radiography evaluation, the anatomic reduction was found in 31 and satisfactory in 7 and unsatisfactory in 1. According to Majeed＇s criteria for the evaluation of therapeutic effect,32 patients obtained an excellent result, and 7 good. Conclusion ： Surgical treatment for unstable pelvic fractures with internal fixation is good for restoring pelvic stability, it can ob- tain good results of long-term follow-up,and also can decrease the rate of disability.

关 键 词：骨折 骨盆 骨折固定术 内 骨折愈合 

分 类 号：R683.3[医药卫生—骨科学]