前路双重建钢板固定结合植骨治疗难复性Tile C型骶髂关节骨折脱位  

Double plate fixation and autogenous bone graft to treat irreducible Tile C sacroiliac joint fracture-dislocation through anterior approach

作　　者：柯顺忠[1] 林焱斌[2] 严康宁[1] 郑亚才[1] 杨荣源[1] 罗艺[1] 王卢林[1] 林提金[1] 

机构地区：[1]福建医科大学附属漳州市医院骨科,福建省漳州市363000 [2]福州市第二医院

出　　处：《中国骨与关节损伤杂志》2014年第3期260-262,共3页Chinese Journal of Bone and Joint Injury

基　　金：福建省医学创新课题(2011-CXB-24)

摘　　要：目的探讨采用前路双重建钢板固定植骨治疗难复性TileC型骶髂关节骨折脱位的临床疗效。方法对39例难复性TileC型骶髂关节骨折脱位采用前路双重建钢板进行固定，取髂骨松质骨植骨。结果所有患者获平均18（8—24）个月的随访，骶髂关节在解剖位或功能位融合。3例术前合并腰骶丛不完全损伤者，在3-4个月内完全恢复。按照Tornetta和Matta复位评定标准：优24例，良8例，可7例，优良率82．1％。根据Majeed功能评分系统：优22例，良9例，可8例。优良率79．5％。结论采用前路双重建钢板固定与植骨治疗难复性TileC型骶髂关节骨折脱位可获得满意复位、固定可靠、稳定性好。有利于骶髂关节融合、并发症少、可使患者早期康复。Objective To evaluate the clinical effectiveness of double plate fixation and autogenous bone graft to treat irreducible Tile C sacroiliac joint fracture-dislocation through anterior approach. Methods Thirty nine patients with irreducible Tile C sacroiliac joint fracture-dislocation were treated with double plate fLxation and autogenous bone graft through anterior approach. Results All patients were followed-up for an average of 18 months （range, 8-24 months）. There was no cases of nonunion of sacroiliac joint in anatomic position or functional position. Three patents with neurological deficiency recovered completely 3 to 4 months postoperatively. The outcomes of reductions were evaluated by Tornetta and Matta criteria： excellent in 24 cases, good in 8 and fair in 7, excellent and good rate was 82.1%.The functional outcomes were determined by Majeed score： excellent results in 22 cases, good in 9, and fair in 8,excellent and good rate was 79.5%. Conclusion Double plate fixation and autogenous bone graft to treat irreducible Tile C sacroiliac joint fracture-dislocation through anterior approach is useful for satisfactory reduction, fixations stability, and fusion, and allows early mobilization.

关 键 词：骶髂关节 骨折脱位 难复性 双钢板 内固定 前路 

分 类 号：R687.3[医药卫生—骨科学]