经皮重建钢板内固定治疗不稳定骨盆后环骨折  

Treatment of unstable pelvic posterior ring fractures with percutaneous reconstruction plate internal fixation

作　　者：陈红卫[1] 赵钢生[1] 潘骏[2] 

机构地区：[1]义乌市中心医院骨科,浙江义乌322000 [2]温州医学院第二附属医院

出　　处：《中国骨伤》2010年第9期708-710,共3页China Journal of Orthopaedics and Traumatology

基　　金：浙江省科技厅基金资助项目(编号:2008C33017)

摘　　要：目的:探讨应用经皮重建钢板内固定治疗不稳定骨盆后环骨折的方法和临床疗效。方法:2004年3月至2008年10月治疗不稳定骨盆后环骨折36例。男26例,女10例;年龄10～65岁,平均37.3岁。牵引复位后,于双侧髂后上棘外侧顺髂嵴做弧形切口,长3～5cm,在患侧将重建钢板通过皮下隧道到对侧,经皮重建钢板内固定治疗。结果:36例均获得随访,时间12～36个月,平均17.8个月。无切口感染,无术中血管神经损伤,无内固定松动及断裂,无骨不愈合,无明显双下肢不等长。平均切口长度、手术时间、术中出血量分别为(4.36±0.99)cm、(42.61±7.97)min、(168.61±40.44)ml。术后功能恢复根据Majeed评价,优12例,良18例,可6例。结论:经皮重建钢板内固定治疗不稳定骨盆后环骨折操作简单、安全、创伤小、恢复快、并发症少,是治疗不稳定骨盆后环骨折的一种比较理想的手术方法。Objective：To analyze the nlethod and clinical effect of percutaneous reconstruction plate internal fixation for the treatment of unstable pelvic posterior ring fractures. Methods ： From March 2004 to October 2008,36 patients with unstable pelvic posterior ring fi＇actures were treated with percutaneous reconstruction plate internal fixation. Heavy traction was used to correct vertical displacement of sacrum, then arc incisions （3-5 cm） were made from both sides of posterior superior iliac spine to ipsilateral inferior iliac spine along iliac crest. The reconstruction plate was pushed through the cutaneously tunnel to the other incision. There were 26 males and 10 females,the age ranged from 10 to 65 years,with an average of 37.3 years old. Re- suits：All the patients were followed up,the duration ranged from 12 to 36 months （means 17.8 months）. There were no infec- tion,no vascular nerve injuries and loosening or breakage of the external fixation. All cases attained bone union and lower limbs were equal. The average length of incisions,operative time and intraoperative blood loss were （4.36＋-0.99） cm, （42.61--- 7.97 ） min, （ 168.61 ＋-40.44） ml, respectively. According to the Majeed standards, the functional recovery was excellent in 12, good in 18 and fair in 6. Conclusion：Percutaneous reconstruction plate internal fixation is an ideally safe and effective way to treat unstable pelvic posterior ring fractures, it has many advantages such as minimal invasion, less complications and quicker recovery.

关 键 词：骨盆 骨折 骨折固定术 内 外科手术 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学]