经皮重建钢板与经皮骶髂螺钉固定治疗Tile C型骨盆后环骨折  

Treating unstable pelvic posterior ring fractures with percutaneous reconstruction plate and percutaneous sacroiliac screws

作　　者：陈红卫[1] 王子阳[1] 黄洪斌[1] 赵品益[1] 赵胜春[1] 陈洵其[1] 叶键[1] 叶招明 潘骏[3] 赵钢生[1] 

机构地区：[1]浙江省义乌市中心医院骨科,322000 [2]断江大学医学院附属第二医院骨科 [3]温州医学院第二附属医院骨科

出　　处：《中华骨科杂志》2009年第11期1019-1022,共4页Chinese Journal of Orthopaedics

基　　金：基金项目：浙江省科技厅面上基金资助项目（2008C33017）

摘　　要：目的对比经皮重建钢板和经皮骶髂螺钉两种内固定方法治疗Tile C型骨盆后环骨折的l临床疗效。方法2002年3月至2007年10月，治疗TileC型骨盆后环骨折患者58例。采用经皮重建钢板内固定治疗29例，男20例，女9例；年龄（37．3±11．3）岁。采用经皮骶髂螺钉固定29例，男21例，女8例；年龄（39．3±10．4）岁。致伤原因：车祸伤38例，高处坠落伤17例，挤压伤3例。记录患者的手术时间、x线暴露次数、术中出血量、切口长度、术后Majeed功能评价、术后并发症等相关数据，进行统计学分析。结果58例均获得随访，随访时间12-36个月，平均21.3个月。两组患者在手术时间、X线暴露次数、切口长度、术中出血量等方面差异有统计学意义。术后Majeed功能评价：经皮重建钢板组优9例，良16例，可4例，优良率为86．1％；经皮骶髂螺钉组优10例，良16例，可3例，优良率为88．2％。结论经皮重建钢板和经皮骶髂螺钉两种内固定方法治疗TileC型骨盆后环骨折疗效相当，但经皮重建钢板较经皮骶髂螺钉固定无神经及血管损伤风险，且术中透视少。Objective To explore the clinical effects of percutaneous reconstruction plate and pereutaneous sacroiliac screws in the treatment of unstable pelvic posterior ring fractures. Methods Fifty-eight patients with unstable pelvic posterior ring fractures underwent percutaneous reconstruction plate and pereuta- neous sacroiliac screws from March 2002 to October 2007. They were divided into 2 groups according to 2 kinds of internal fixations： pereutaneous reconstruction plate （20 males and 9 females, with the mean age of 37.3±11.3 years） and perentaneous sacroiliac screws （21 males and 8 females, with the mean age of 39.3±10.4 years）. Thirty-eight cases were caused by motor vehicle accident, 17 by fall from height and 3 by crush. The da- ta of operative time, X-ray exposure frequency, intro-operative blood loss, length of incision, post-operative Ma- jeed standards and post-operative complication were recorded and analyzed statistically using the SPSS 15.0 software package. Results All patients were follow up 12-36 months （mean 21.3 months） in 58 patients. There were significant differences in operative time, X-ray exposure frequency, intro-operative blood loss and length of incision between the two groups. According Majeed standards, the excellent and good rate was 86.1% in recon- struction plate, and 88.2% in sacroiliac screws. Conclusion Unstable pelvic posterior ring fractures could be treated successfully with percutaneous sacroiliac screws and percutaneous reconstruction plate. There were no significant differences in clinical outcomes between the two groups. However, percutaneous reconstruction plate shows some advantages, such as less operative time, less fluoroscopy time and less complication.

关 键 词：骨盆 骨折 骨螺丝 骨板 

分 类 号：R686[医药卫生—骨科学]