双侧骶1椎弓根螺钉结合髂骨螺钉固定治疗骶髂复合体损伤临床疗效观察  

Bilateral S1 pedicle screws combined with iliac screws fixation in treatment of sacroiliac complex injury

作　　者：陈四木[1] 高志朝[1] 孟永骏[1] 付悦渊[1] 徐卫星[2] 

机构地区：[1]杭州师范大学医学院附属余杭医院骨科,杭州311100 [2]浙江省立同德医院骨科

出　　处：《浙江医学》2013年第7期547-549,552,共4页Zhejiang Medical Journal

摘　　要：目的探讨双侧骶1椎弓根螺钉结合髂骨螺钉固定技术在治疗骶髂复合体损伤中的临床疗效。方法对23例骶髂复合体损伤患者,采用后路切开复位、双侧骶l椎弓根螺钉与伤侧髂骨螺钉连接固定后环,外固定支架固定前环的方法治疗。结果 23例患者均可在术后l^3d床上450~600半卧位坐起,能使下肢足跟不离床面作屈伸髋膝关节及45°左右侧卧,而骶髂部无明显不适;术后影像学检查显示骨折和/或脱位获得解剖或接近解剖复位。21例获得随访。随访时间10~19个月,均能正常行走,仅1例56岁患者劳累后出现腰骶部酸痛,余均无明显骶髂关节疼痛等后遗症,功能恢复良好,疗效满意。结论后环双侧骶1椎弓根螺钉结合伤侧髂骨螺钉固定、前环外固定支架固定治疗骶髂复合体损伤,具有疗效确切、并发症及后遗症少、护理方便等优点。临床应用安全可行。Objective To evaluate the clinical effect of bilateral S1 pedicle screws combined with iliac screws fixation in treatment of sacroiliac complex injury. Methods Twenty three patients with sacroiliac complex injury were included in the study. After posterior open reduction, the rear rings were fixed by the bilateral sacral pedicle screws and iliac screws, and the anterior rings were fixed by external fixator. Results Al 23 patients were able to sit up in semi-recumbent position （ranged, 45°to 60°） in 1~3 days after surgery and make the hip and knee flexed and extended on bed and be side lying in 45°. Al patients obtained satisfactory clinical results and replacement of sacroiliac complex dislocation. Twenty one cases were fol owed up for 10~19 months; 1 case presented lumbosacral pain was relieved by rest, others obtained satisfactory clinical results. Conclusion The bilateral S1 pedicle screws combined with iliac screws fixation is safe and effective in treatment of sacroiliac complex injury.

关 键 词：骶髂复合体 椎弓根螺钉 髂骨螺钉 骨折固定术 

分 类 号：R687.3[医药卫生—骨科学]