经后侧入路手术治疗骨盆新月形骨折  

Operative treatment of crescent fracture of the pelvis by posterior approach

作　　者：秦晖[1] 安智全[1] 姜朝来[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科创伤第三病区,200233

出　　处：《中华创伤骨科杂志》2011年第9期822-826,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨经后侧人路手术治疗骨盆新月彤骨折的疗效。，方法2007年4月至2010年1月采用经后侧人路手术治疗12例骨盆新月形骨折患者，男8例，女4例；年龄21～55岁，平均31．3岁；左侧6例，右侧6例。致伤原因：交通伤8例，高处摔伤3例，重物压伤1例；对于骨缸，均为侧方的挤压暴力。骨折根据Tile分型：B2．1型8例，B2．2型4例。12例患者均采用经后侧人路行切开复位内固定治疗。受伤至手术时间为3～9d，平均6．2d。记录手术时间、术中失血量、手术纠正骨盆后环骨折移位情况、骨折愈合时间及Hannover骨盆评分。结果本组患者手术时间平均为（172．5±34．1）min（120～240min），手术失血量平均为（412．5±128．1）mL（250～700mL），于术纠正移位平均为（11．7±4．6）ram（6～21mm），12例患者复位结果均为优。10例患者术后获12～20个月（平均16．3个月）随访。X线片示所有患者骨折均获愈合，愈合时间平均为（3．1±0．3）个月（3～4个月），无骨折复位丢，大及内间定失效发生。按照Hannover骨盆评分标准评定疗效：临床症状恢复：优7例，良3例；重返社会能力：完全重返8例，部分霞返2例。结论经后侧人路手术治疗骨盆新月形骨折足一种较好的选择，可以取得良好疗效。Objective To explore the efficacy of posterior approach in treatment of crescent pelvicfracture. Methods Between April 2007 and January 2010, 12 patients with crescent pelvic fracture were treated via posterior approach at our department. They were 8 men and 4 women, aged from 21 to 55 years （average, 31.3 years）. Six left and 6 right sides were affected. The fractures were caused by a traffic accident in 8 cases, high falling in 3 cases and heavy weight crushing in one. By Tile classification, there were 8 cases of type B2. 1 and 4 cases of B2.2. The time from injury to operation was 3 to 9 days, with an average of 6.2 days. They were treated with open reduction and internal fixation via the posterior approach. Operation time, intraoperative blood loss, postoperative loss of pelvic ring reduction, fracture healing time and Hannover pelvic outcome scoring were documented. Results The average operation time was 172.5 ±34. 1 minutes（from 120 to 240 minutes） . The average blood loss was 412.5±128. 1 mL（from 250 to 700 mE） . The average reduction gained was 11.7±4.6 mm（from 6 to 21 mm）, Ten patients obtained an average follow-up of 16.3 months （from 12 to 20 munths）. The X-ray films showed bony healing in all patients after an average of 3. 1 ±0.3 months（from 3 to 4 months）. There was no postoperative loss of pelvic, ring reduction or implant failure. By the Hannover scoring system, 7 patients were rated as excellent and 3 as good in clinic symptoms, and complete social reintegration was obtained in 8 cases and incomplete one in 2 cases. Conclusion Operation via posterior approach is a good choice for treatment of crescent pelvic fracture.

关 键 词：骨盆 骨折 骶髂关节 骨折固定术 内 

分 类 号：R687.3[医药卫生—骨科学]