耻骨联合分离为主要损伤表现的Tile B型骨盆骨折的微创治疗  

Minimally invasive treatment of Tile B pelvic fractures with pubic symphysis separation as the main damage performance

作　　者：张平[1] 李光磊[1] 关育忠 王冠[1] 

机构地区：[1]淄博市临淄区人民医院骨一科,山东255400

出　　处：《中国骨与关节杂志》2015年第6期456-459,共4页Chinese Journal of Bone and Joint

摘　　要：目的：探讨耻骨联合分离为主要损伤表现的 Tile B 型骨盆骨折的微创治疗方法及疗效。方法2013年2月至2014年3月，对9例以耻骨联合分离为主要损伤表现的 Tile B 型骨盆骨折，通过合理的体位安置，体外无损伤闭合复位，经皮空心螺钉内固定治疗。结果手术时间30～70 min，平均45 min，单枚螺钉置钉失血量1～6 ml，平均3 ml，无钉道感染及穿刺并发症发生。复位情况根据 Matta 标准评价：9例均优。术后6周、3个月复查 X 线片，未出现螺钉松动、断裂。随访5～10（平均8.3）个月，临床功能恢复情况根据 Majeed 标准评价：9例均优。结论利用体外闭合复位技术，经皮空心螺钉内固定治疗以耻骨联合分离为主要损伤表现的 Tile B 型骨盆骨折，可简化操作，缩小手术创伤，效果肯定。Objective To explore the minimally invasive treatment methods and corresponding curative results of Tile B pelvic fractures with pubic symphysis separation as the main damage performance.Methods From February 2013 to March 2014, 9 patients with Tile B pelvic fractures with pubic symphysis separation as the main damage performance were admitted. All the patients were treated by noninvasive closed reduction in vitro and percutaneous cannulate screw ifxation. Fracture closure was achieved by reasonable positioning.Results The average operative time was 45 min （ range： 30-70 min ）, and the average intraoperative blood loss was 3 ml （ range： 1-6 ml ）. No incision infections or puncture-related complications occurred. Reduction of fractures was assessed by Matta’s criteria, and there were 9 excellent cases. The pelvic X-ray films at 6 weeks and 3 months after the surgery were reviewed in all the patients, and no screw loosening or breakage was found. The average follow-up period was 8.3 months （ range： 5-10 months ）. According to Majeed functional scoring, all the patients were excellent. Conclusions Invitro closed reduction techniques are used and percutaneous cannulate screw ifxation is carried out in the treatment of Tile B pelvic fractures with pubic symphysis separation as the main damage performance, with the advantages of simple operation, less trauma and satisfactory results.

关 键 词：耻骨联合 骨盆 骨折 外科手术 微创性 创伤和损伤 

分 类 号：R687.3[医药卫生—骨科学]