桥接组合式内固定系统治疗骨盆骨折  

Treatment of pelvic fracture with Ortho-Bridge system

作　　者：赵烽[1] 陆继鹏[1] 熊鹰[1] 普淇[1] 杨宏锟[1] 白力承 任云峰[1] 吴中雄[1] 耿承奎[1] 杨斌[1] 

机构地区：[1]昆明医科大学附属延安医院骨科,昆明650051

出　　处：《中国矫形外科杂志》2016年第10期889-893,共5页Orthopedic Journal of China

摘　　要：[目的]探讨桥接组合式内固定系统治疗骨盆骨折的临床效果。[方法]应用该系统治疗各类骨盆骨折共43例。按骨盆骨折Tile分型标准,B型骨折26例,C型骨折17例。术中根据骨盆损伤类型,采用不同的手术切口。术后参照Matta评分系统评价骨折复位情况,按Majeed功能评分系统评价术后功能情况。[结果]随访12-24个月,所有患者骨折均愈合,术后伤口感染2例,静脉血栓1例,经换药和专科治疗痊愈;无骨不连、内固定松动、断裂、患肢短缩、骨盆倾斜等并发症,按Matta复位标准：优37例,良6例。临床功能方面：3例合并坐骨神经损伤患者,2例恢复正常,1例遗留轻度肢体麻木疼痛,1例医源性股神经牵拉伤,末次复查时症状基本消失;3例遗留习惯性跛行,大部分患者恢复原来的学习和工作;多数患者反映对就座、站立和性生活无明显影响;Majeed功能评分：优31例,良8例,中4例,总优良率为91%。[结论]桥接组合式内固定系统具有操作灵活、固定可靠、适应证广等诸多优点,理论上可应用于骨盆任何部位的骨折。它是一种集锁定钢板、髓内钉及外固定架优势为一体的新型骨科内固定装置,值得进一步尝试和探索。[Objective]To investigate the clinical outcomes of Ortho- Bridge system in the treatment of pelvic fracture. [ Method ] Forty - three patients with pelvic fractures were treated with Ortho - Bridge system. By Tile classification, there were 26 cases of type B and 17 cases of type C. According to the pattern of pelvic injury, open reduction and internal fixation with Ortho - Bridge system was done through different surgical approaches. The reduction quality was evaluated according to the Matta criteria,functional outcome was assessed according to the Majeed criteria. [ Result] All the patients were followed up for 12 to 24 months. All fractures bony healed,with 2 cases of wound infection, 1 case of venous thrombosis,while healed after debride- ment and specialist treatment. No nonunion, internal fixation loosening or breakage, limb shortening, pelvic tilt were seen in these cases. The Mattag criteria of quality of reduction was graded as being excellent in 37, good in 6. Three cases of sciatic nerve le- sion were found preoperatively ,2 cases of them recovered postoperatively, 1 case remained mild limb numbness and pain. Iatro- genic injury of the femoral nerve was found in 1 case, the symptoms disappeared at the final follow - up. In another 3 cases, ha- bitual claudication was remained but did not effect their normal work and life. Most of the patients resumed their preoperative quality of life, the surgery did not obviously effect the seating, standing, and sexual life. According to Majeed score, excellent out- comes were achieved in 31 cases, good in 8 cases, fair in 4 cases, the excellent and good outcomes rate was 91%. [ Conclusion ] The Ortho -Bridge system has many advantages, such as flexible operation, reliable fixation,wide adaptation, et al. It can be ap- plied to almost any part of the pelvic fracture. At the same time, it is an instrument combined the advantages of locking plate,in- tramedullary nail and external fixation frame.

关 键 词：骨盆 骨折固定术 内固定装置 

分 类 号：R687.3[医药卫生—骨科学]