后环内固定加前环外固定治疗不稳定性骨盆骨折  

The Internal Fixation of the Posterior Pelvic Ring Injuries with an External Fixator of the Previous Pelvic Ring Injuries in the Treatment of Unstable Pelvic Fractures

作　　者：王炳臣 毛军胜[1] 石恩东[1] 张凯[1] 林咏杰 王国伟[1] 黄抗美[1] 王鹏[1] 

机构地区：[1]山东省交通医院骨科,山东济南250031

出　　处：《实用骨科杂志》2010年第12期881-883,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨骨盆后环内固定术加前环外固定支架固定术治疗不稳定性骨盆骨折的疗效。方法 2005年1月至2008年7月共治疗不稳定性骨盆骨折17例,男14例,女3例,年龄16-57岁,平均34岁。腹股沟处骨折端外露1例,合并盆腔脏器损伤5例,股动脉损伤后血栓1例,腰骶神经损伤5例,下肢骨折4例,胸部外伤1例。均行快速复苏,12例同时行骨盆骨折外固定支架外固定术,复苏后行后环切开复位内固定术、继续前环外固定支架固定治疗;5例复苏后行后环切开复位内固定术、同时行前环外固定支架固定治疗。结果随访6-48个月,平均20.6个月,按照Co le等骨盆骨折效果评分表进行功能评价,17例中功能恢复优12例,良3例,可2例,差0例,优良率88.2%。无死亡病例,无切口感染,有2个钉道感染,无医源性损伤,腰骶神经损伤完全恢复3例,部分恢复2例。结论采取后环内固定术加前环外固定支架固定术治疗骨盆不稳定性骨折,可以获得稳定固定,疗效可靠,且手术操作简单、安全,创伤小、并发症少。Objective To explore the clinical treatment of unstable fracture of pelvic.That was the clinical features and the result of the treatment of unstable fracture of pelvic with the internal fixation of the posterior pelvic ring injuries and an external fixator of the previous pelvic ring injuries.Methods 17 cases of unstable pelvic fractures were identified,14 males and 3 females,aged 16 years to 57 years,with an average 34 years old.Groin exposed fracture in 1 case,and pelvic organ injury in 5 cases,femoral artery thrombosis after injury in 1 case,lumbar sacral nerve injury in 5 cases,4 cases of lower limb fractures,chest trauma in 1 case,which of them were treated with fast recovery.At the same time 12 cases of pelvic fracture ware treated with external fixation.After recovery,the posterior pelvic ring injuries was treated with the internal fixation,and that five cases treat with the internal fixation and external fixation simultaneously.Results All the patients had been followed up for the average of 20.6months（range 6 to 48 months）.Satisfactory results were obtained,according to Cole′s evaluation,Excellent functional recovery of 12 cases,good in 3 cases and 2 cases and poor in 0 cases,excellent rates 88.2%.There are 2 screw tract infections with no deaths,no incision infection and lumbosacral nerve injury in 3 cases completely recovery and 2 cases of partial recovery.Conclusion The clinical treatment of unstable fracture of pelvic with the internal fixation of the posterior pelvic ring injuries and an external fixator of the previous pelvic ring injuries obtain stable fixation,efficacy and reliable.The procedure is simple,safe,trauma and less complications.

关 键 词：骨盆骨折 内固定 外固定支架 

分 类 号：R683.3[医药卫生—骨科学]