内固定与外固定材料修复骨盆骨折损伤:合理选择与生物相容性  

Internal and external fixation materials for the repair of pelvic fracture: reasonable choice and biocompatibility

作　　者：郎毅[1] 融恺[1] 陈平波[1] 

机构地区：[1]新疆医科大学附属中医医院骨四科,新疆维吾尔自治区乌鲁木齐市830000

出　　处：《中国组织工程研究》2016年第31期4700-4706,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:骨盆骨折多为高能量损伤所致,随着影像学技术的发展及对骨盆解剖结构和生物力学的深入研究,内固定和外固定材料在骨盆骨折损伤修复中逐渐被应用。目的:综述骨盆骨折后外固定支架材料、经皮螺钉固定、经皮骶髂螺钉内固定材料和髓内拉力螺钉内固定材料的特点及应用。方法:通过参阅1994至2015年万方数据库和PubM ed数据库有关内固定材料、外固定材料在骨盆骨折中应用的文献,进行分析、综合并归纳。结果与结论:骨盆外固定材料的应用有助于早期骨盆骨折骨折块的稳定且损伤小,可增加固定的可靠性,但单纯外固定材料提供的生物力学稳定性较其他内固定差,只可用于特定情况下不稳定型骨盆骨折的早期临时固定;内固定材料可达到解剖复位,符合骨盆生理力学要求,能提高骨盆稳定性,已成为修复不稳定骨盆骨折的首选,目前常用的有经皮空心螺钉内固定、经皮骶髂螺钉内固定、髓内拉力螺钉内固定等。将外固定与内固定材料结合也能够有效恢复骨盆腔稳定性,因此应综合考虑骨折部位、类型、稳定程度等选择合适的内固定和外固定材料。BACKGROUND： Pelvic fractures are mostly caused by high energy trauma. With the development of imaging techniques and in-depth study of the anatomical structure of the pelvis and biomechanics, internal fixation and external fixation materials are gradually being used in the repair of pelvic fracture. OBJECTIVE： To summarize features and applications of external fixation stent material, percutaneous screw fixation, percutaneous sacral lilac screw material for internal fixation and intramedullary tensile screw material for internal fixation after pelvic fracture. METHODS： We retrieved Wanfang Database and PubMed for studies on the application of internal fixation material and external fixation material in pelvic fracture from 1994 to 2015. All data were analyzed and summarized. RESULTS AND CONCLUSION： Application of pelvic external fixation materials contributed to the stability of early pelvic fractures, showed small injury, could increase the reliability of fixation. However, the biomechanical stability of external fixation materials was lower than other internal fixation, could only be used for the early temporary fixation of unstable pelvic fractures in particular cases. Internal fixation materials can achieve anatomical reduction, accorded with the requirements of the physical mechanics of the pelvis, improve the stability of the pelvis, and have become the first choice for repair of unstable pelvic fractures. Currently used methods are percutaneous hollow screw fixation, percutaneous fixation of the sacral lilac screw, and intramedullary lag screw fixation. The combination of external fixation and internal fixation can effectively restore the stability of the pelvic cavity. Therefore, we should consider the location, type and stability of the fracture to select the appropriate internal fixation and external fixation materials.

关 键 词：骨盆 内固定器 外固定器 组织工程 骨科植入物 骨植入物 骨盆骨折 稳定性 修复 重建 内固定材料 外固定材料 

分 类 号：R318[医药卫生—生物医学工程]