骶髂关节骨折脱位的手术治疗  

Surgical treatment of sacroiliac joint fracture-dislocation

作　　者：吴焯鹏[1] 匡光志[1] 冯华杰[1] 劳维蔼[1] 唐国瑜[1] 谢国均[1] 

机构地区：[1]广东省开平市中心医院骨外科,广东开平529300

出　　处：《生物骨科材料与临床研究》2010年第3期21-23,共3页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的回顾性分析26例骶髂关节骨折脱位的内固定方法和临床疗效,探讨骶髂关节骨折脱位的手术方法。方法对26例骶髂关节骨折脱位的TileC型骨盆骨折病例,16例采用经皮骶髂关节空心螺钉技术固定骨盆后环,10例采用骶髂关节前路钢板技术固定骨盆后环,所有病例同时固定骨盆前环,采用Majeed功能评分进行疗效评定。结果随访6个月～6年,平均2年3个月,本组病例术后未发生骶神经损伤、伤口感染等并发症,X线片示骶髂关节复位及内固定位置良好。根据Majeed功能评分,优9例,良10例,优良率达73.1%。结论对于骶髂关节骨折脱位的TileC型骨盆骨折,经皮骶髂关节空心螺钉和骶髂关节前路钢板均可重建骨盆后环的稳定性。而经皮骶髂关节空心螺钉固定具有固定坚强、损伤小等优点,值得推广应用,但操作技术要求高,并要注意防止手术并发症的发生。Objective Retrospectively analysed the internal fixation and clinical efficacy of 26 cases of sacroiliac joint fracture-dislocation and discuss the surgical method.Methods In 26 patients with sacroiliac joint fracture-dislocation of Tile C pelvic fracture cases,16 patients were treated with the combined use of cannulated screw fixation technique and pelvic anterior plate fixation technique,10 patients were treated with the combined use of pelvic posterior plate fixation technique and pelvic anterior plate fixation technique,all the cases using the evaluation criterion of Majeed for efficacy evaluation.Results The follow-up 6 months to 6 years,an average of 2 years and 3 months,patients in this group did not occur after sacral nerve injury,wound infection and other complications,x-ray film showed sacroiliac joint reduction and internal fixation in good position.According to the evaluation criterion of Majeed,excellent outcomes were obtained in 9 cases,good in 7 cases,excellent rate was 73.1%.Conclusion For the sacroiliac joint fracture-dislocation of TileC pelvic fractures,cannulated screw fixation technique and posterior plate fixation technique both can reconstruct the pelvic stability.cannulated screw fixation with fixed strong,less damage,etc.,should promote the use,but must pay attention to prevent surgical complications.

关 键 词：骨盆骨折 骶髂关节 关节损伤 内固定 

分 类 号：R687.3[医药卫生—骨科学]