有限切开结合经皮螺钉治疗C型骨盆骨折的疗效分析  

Analysis of Curative effect of limited incision combined with percutaneous screw for typec pelvic fracture

作　　者：王文合[1] 

机构地区：[1]广东博罗县人民医院,博罗516100

出　　处：《河南外科学杂志》2015年第4期8-10,共3页Henan Journal of Surgery

摘　　要：目的 观察有限切开结合经皮拉力螺钉治疗C型骨盆骨折的临床疗效。方法 选取2010-05—2013-12间42例TILE C型骨盆骨折患者做为观察组,术前行股骨髁上骨牵引闭合复位后,于X线透视下行有限切开耻骨钢板固定联合骶髂关节拉力螺钉固定。同时选取2008-01—2010-01间的38例C型骨盆骨折行传统切开复位内固定术的患者作为对照组,比较2组患者手术时间、术中出血量。术后随访3~6个月,比较2组骨折复位情况、愈合时间、患肢功能和并发症发生情况。结果 观察组手术时间和术中出血量均低于对照组,2组比较,差异有统计学意义（P〈0.05）。2组骨折解剖复位率差异无统计学意义（P〉0.05）。观察组愈合时间（2.5±0.3）个月,低于对照组（3.1±0.4）个月。Majeed评分观察组优良率96%（40/42）,高于对照组82%（31/38。观察组无1例发生髋内翻畸形、腰骶神经损伤、下肢深静脉血栓和脂肪栓塞等并发症,对照组并发症发生率7.9%（3/38）,其中2例发生神经损伤,1例发生深静脉血栓,2组比较,差异有统计学意义（P〈0.05）。结论 有限切开结合经皮拉力螺钉治疗C型骨盆骨折,手术创伤小、并发症少、固定牢靠、术后功能恢复好。Objective To observe the clinical effect of limited incision combined with percutaneous lag screw for type C pelvic frac- ture. Methods Totally 42 patients with TILE type C pelvic fracture selected in our department from 2010 May to 2013 in Decenlber, done closed traction reduction of femoral supracondylar, in X- ray fluoroscopy conduct limited internal fixation combined with iliosacral screw fixa- tion, at the sam;e time select the 2008 January- 2010 January 38 patients with type C pelvic fractures treated with traditional open reduction and internal fixation patients as control group compared, the amount of bleeding and operation time, postoperative follow - up of 3 - 6 months, compared two groups fracture reduction, healing time, limb function and complications. Results The observation group operation time and bleeding volume during operation were lower than that of the control group（ P 〈 0. 05 ）. X-ray examination of two groups of anatomical reduction rate of the fracture showed no significant difference（ P 〉 0. 05 ）, the healing time of observation group was （ 2.5 ± 0. 3 ） months, lower than that of the control group （3. 1 ±0. 4） months（P 〈0. 05） ; the Majeed score in observation group, the excellent and good rate was 96% （40/42） , more than that of control group 82% （31/38 ）. Complications, observation group no one a case of hip varus, lumbosacral nerve injury, deep ve- nous thrombosi of lower extremity and fat embolism, and 2 cases in the control group had the nerve injury, 1 case of deep vein thrombosis, the incidence was 7.9% （3/38）, the difference was statistically significant （ P 〈 0. 05 ）. Conclusion Limited incision combined with percutaneous lag screw for type cpelvic fracture, the operation has little trauma, less complications, reliable fixation, good postoperative function recovery＇, can be popularized in clinic.

关 键 词：骨盆骨折 经皮拉力螺钉 有限切开 疗效 

分 类 号：R683.3[医药卫生—骨科学]