骶髂前路蝶形钢板与传统重建钢板治疗骶髂关节损伤的比较研究  

Sacroiliac anterior papilionaceous plate in the treatment of sacroiliac joint disruption： clinical application, and short-term outcome

作　　者：王国栋[1] 周东生[1] 谭国庆[1] 李连欣[1] 李庆虎[1] 

机构地区：[1]山东大学附属省立医院(山东省骨科医院)创伤骨科,250021济南

出　　处：《中华骨科杂志》2013年第5期541-548,共8页Chinese Journal of Orthopaedics

摘　　要：目的比较骶髂前路蝶形钢板（sacroili acanterior papilionaceous plate，SAPP）和传统晕建钢板在骶髂关节损伤治疗中的疗效。方法回顾性分析2012年1月至2012年10月治疗23例24侧骶髂关仃损伤的病历资料，ll例11侧行SAPP内固定，男5例，女性6例；平均年龄为（39．6±9．1）岁；Tile B喇骨折6例，C型5例。12例13侧行传统重建钢板内固定，男7例，女5例；平均年龄为（39．1±13．5）岁；Tile B型骨折7例，C型5例。两组间比较差异均无统计学意义。记录术中手术时间、出血量、骶髂关肖钢板放置时间等，术后即刻行X线榆佥及Matta评分，术后随访时行X线检查及Majeed功能评分。结果SAPP组平均手术时间（98．2±31．4）min，出血量（989．7±365．9）ml，钢板放置时间（6．6±3．2）min。传统重建钢板组平均r术时间（110．8±29．6）min，出血量（1136．0±279．3）ml，钢板放置时间（15．4±1．1）rain。SAPP纰术后Matta评分优4例、良5例、可2例，传统晕建钢板组优4例、良6例、可1例、差l例。术中大出血2例，术后出现腰骶干损伤l例，股外侧皮神经损伤7例。SAPP组与传统重建钢板组相比，钢板放置时间明显缩短，Tile B型骨折出血量明显减少，余差异均尤统计学意义。结论骶髂前路蝶形钢板应用于骶髂关节损伤能够获得满意的复位和良好的固定，同传统重建钢板相比较，能易化操作、缩短放置时间、有利于旋转复位、可以减少B型骨折的出血艟，并不增加神经损伤风险及感染率。Objective To compare the effect of sacroiliac anterior papilionaceous plate （SAPP） andthe traditional reconstruction plate for the treatment of sacroiliac joint disruption. Methods 11 consecutive patients with sacroiliac joint disruption associated with pelvic fracture enrolled in our hospital. Detailed physical examination, X-rays, CT and FAST were performed before surgery. 11 patients underwent SAPP fixation. Of the 11 patients, there were 5 males and 6 females. Their average age was 39.6 years. 12 patients enrolled in last year as control group underwent reconstruction plate. There were 7 males and 5 females in tihs group. Their average age was 39.1 years. Operation time, blood loss, placing time of SAPP were recorded. X-ray films were performed ＇after surgery to evaluate reduction condition by Matta criteria. X-ray films and Majeed outcome were performed in follow up. Results According to Tile classification, there were 13 Type B and 10 Type C. For SAPP group, operation time was （100.9±32.1） min, blood loss （998.8±365.7） ml, Placing time of SAPP was （6.6±3.2） min. For control group, operation time was （110.8±29.6） rain, blood loss was （136.0±279.3） ml, placing time of reconstruction plate was （15.4±1.1） rain. According to Matta criteria, 8 cases were rated as excellent, l I as good, 3 as fair, and I as poor. l,umbosacral nerve injury occurred in 1 case, lateral femoral cutaneous nerve injury in 7, and massive blood loss in 2 cases. No posterior infection occurred. Compared with control group, SAPP group experienced shorter placing time, and less blood loss in type B pelvic fracture. Conclusion As a new instrument, SAPP could be well applied in the treatment of sacroiliac disruption. Compared with reconstructed plate, SAPP obviously shortens placing time and facilitated placing procedure, and does not increase blood loss, neurological risk and infection rate and does not need different incision and reduction method.

关 键 词：骨盆 骶髂关节 骨折 骨折固定术 内 

分 类 号：R687.3[医药卫生—骨科学]