椎弓根螺钉内固定系统治疗骨盆前环骨折的疗效分析  

Effect of pedicle screw rod internal fixation system in the treatment of anterior pelvic ring fracture

作　　者：桂龙云[1] 江云云 袁中山[1] GUI Long-yun;JIANG Yun-yun;YUAN Zhong-shan(Spine Ward of Orthopaedics,Tongling People s Hospital of Anhui Province,Tongling,Anhui 244000,China)

机构地区：[1]铜陵市人民医院骨科脊柱病区,安徽铜陵244000

出　　处：《创伤外科杂志》2020年第7期529-531,共3页Journal of Traumatic Surgery

基　　金：2016年安徽省卫生和计划生育委员会科研计划项目(2016QK007)。

摘　　要：目的探讨应用椎弓根钉棒内固定系统(INFIX)治疗骨盆骨折前环损伤的临床疗效。方法回顾性分析2016年9月—2019年7月铜陵市人民医院骨科应用INFIX技术治疗骨盆骨折前环损伤16例,其中男性11例,女性5例;年龄34~65岁,平均50.5岁;坠落伤4例,道路交通伤8例,重物砸伤4例。骨盆骨折Tile分型:Tile B型9例,Tile C型7例;前环骨折类型:双侧坐耻骨支骨折10例,单侧坐耻骨支骨折3例,耻骨支Ⅰ区及Ⅲ区骨折1例,耻骨联合分离合并双侧坐耻骨支骨折1例,耻骨联合分离1例。固定方式:在髂前下棘外缘分别拧入1枚合适长度椎弓根螺钉,经皮下在两椎弓根螺钉间置入连接杆。观察手术时间、术中出血量、Matta标准评价骨折复位质量、骨折愈合情况及并发症。结果16例经平均6个月(3~12个月)随访,平均手术时间60.5min(52~71min),平均术中出血量30.2mL(15~40mL)。患者在平均12.6周(9~15周)时骨折均愈合,1例出现切口浅层感染,6侧出现股外侧皮神经刺激症状。骨折复位质量优良率93.75%。结论利用INFIX技术治疗骨盆前环骨折,创伤小,操作简易,安全性高,固定牢靠,临床疗效满意,是固定骨盆骨折前环损伤的理想方式。Objective To explore the clinical effect of pedicle screw rod internal fixation system(INFIX)in the treatment of anterior pelvic ring fracture.Methods From Sep.2016 to Jul.2019,16 patients with anterior pelvic ring fracture were treated with INFIX technique,including 11 males and 5 females,with an average age of 50.5 years(range from 34 to 65 years).The causes of injury were fall injury(n=4),traffic accident injury(n=8)and heavy object injury(n=4).According to the Tile classification of pelvic fracture,there were 9 cases of Tile B and 7 cases of Tile C.The types of anterior ring fractures included bilateral ischiopubic branch fracture(n=10),unilateral ischiopubic branch fracture(n=3),pubic branchⅠandⅢfracture(n=1),pubic symphysis separation combined with bilateral ischiopubic branch fracture(n=1)and pubic symphysis separation(n=1).The method of fixation:a suitable length pedicle screw was put into the outer edge of the anterior inferior iliac spine,and the connecting rod was placed subcutaneously between the two pedicle screws.The operation time,intraoperative blood loss,fracture healing and complications were observed.Results The average follow-up time was 6 months(ranged from 3 to 12months),the average operation time was 60.5 minutes(52-71min),and the intraoperative blood loss was 30.2 mL(15-40mL).All patients healed at an average of 12.6 weeks(9 to 15 weeks).One patient developed superficial incision infection;6 patients showed lateral femoral cutaneous nerve stimulation symptoms.The excellent and good rate was 93.75%.Conclusion The use of INFIX technique in the treatment of anterior pelvic ring fracture has the advantages of less trauma,simple operation,high safety,reliable fixation and satisfactory clinical effect.It is an ideal method to fix the injury of anterior pelvic ring fracture.

关 键 词：骨盆骨折 椎弓根 内固定 前环损伤 疗效 

分 类 号：R683.3[医药卫生—骨科学]