微创内固定治疗不稳定骨盆后环骨折  

Minimally Invasive Fixation for Unstable Pelvic Posterior Ring Fractures

作　　者：张根福[1] 陈红卫[1] 

机构地区：[1]浙江省义乌市中心医院骨科,322000

出　　处：《中国骨与关节损伤杂志》2011年第2期103-105,共3页Chinese Journal of Bone and Joint Injury

基　　金：浙江省科技厅面上基金资助项目(2008C33017)

摘　　要：目的探讨经皮重建钢板和经皮骶髂螺钉两种内固定方法治疗不稳定骨盆后环骨折的临床疗效。方法自2002年1月-2008年10月．对不稳定骨盆后环骨折70例分别采用经皮重建钢板内固定36例，经皮骶髂螺钉内固定34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70例均获得随访。时间12-36个月，平均23．9个月。两组患者的手术时间、X线暴露次数、切口长度及术中出血量比较差异有统计学意义（P〈0．01），术后根据Maieed功能评价，经皮重建钢板内固定组的优良率为86．1％，经皮骶髂螺钉内固定组为88．2％，两组比较差异无统计学意义。两组患者术后均无切口感染，无术中血管损伤，无内固定松动及断裂，无骨不愈合，术后并发症等方面差异无统计学意义（X^2=2．057,P=0．151）。结论两种方法均具有固定可靠、手术创伤小、并发症少、恢复快等优点。Objective To analyze the clinical effects of percutaneous reconstruction plate and percutaneous sacroiliac screws in the treatment of unstable pelvic posterior ring fractures. Methods Seventy cases of unstable pelvic posterior ring fractures underwent percu- taneous reconstruction plate and percutaneous sacroiliac screws from January 2002 to October 2008.They were divided into two groups ac- cording to patterns of internal fixation： percutaneous reconstruction plate （n=36） and percutaneous sacroiliac screws （n=34）. The data of operative time, X-ray exposure frequency, intraoperative blood loss volume, length of the incision, Majeed＇ s grading score scale for func- tional evaluation and postoperative complications were recorded and analyzed statistically using SPSS 15.0 software package. Results Seventy cases were all followed up, the duration was 12-36 months, mean being 23.9 months. There were significant differences in opera- tive time, X-ray exposure frequency, intraoperative blood loss volume and length of incision between two groups. Postoperative evaluation under Majeed, percutaneous reconstruction plate group＇s excellent rate was 86.1%, percutaneous sacroiliac screw group＇s excellent rate was 88.2%,compared to the differences between the two groups was not statistically different. There were no infection, no vessel injuries and loosening or breakage of the screw. All cases attained bone union. The postoperative complications were not statistically different （X^2= 2.057,P=0.151）.Conclusion Both ways have many advantages such as minimal invasion, reliable fixation, less complication and quick recovery.

关 键 词：骨盆骨折 经皮内固定 骶髂螺钉 重建钢板 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学]