经皮空心钉固定骶髂关节脱位合并耻骨支骨折  

Percutaneous cannulated screw for sacroiliac dislocation combined with pubic fracture

作　　者：杨锡明[1] 于蕾[2] 刘志[1] YANG Xi-ming;YU Lei;LIU Zhi(Department of Traumatic Orthopaedics,Tengzhou Central People's Hospital,Tengzhou 277500,China;School of Medical Technology,Zaozhuang Vocational College of Science and Technology,Tengzhou 277500,China)

机构地区：[1]滕州市中心人民医院创伤一科,山东滕州277500 [2]枣庄科技职业学院医学技术系,山东滕州277500

出　　处：《中国矫形外科杂志》2020年第18期1642-1645,共4页Orthopedic Journal of China

基　　金：济宁医学院教师科研扶持基金(编号:JY2017FS039)。

摘　　要：[目的]评价经皮空心钉内固定骶髂关节脱位合并耻骨支骨折的临床疗效。[方法] 2014年1月~2018年12月,35例关节脱位合并耻骨支骨折患者纳入本研究。其中,14例行经皮空心钉固定,21例行髂腹股沟入路开放复位内固定。比较两组间围手术期、随访和影像资料。[结果]经皮组术中出血量和手术时间均显著优于开放组(P<0.05),经皮组早期总体并发症发生率显著低于开放组(P<0.05)。随术后时间延长,两组患者VAS评分显著下降(P<0.05),而Majeed评分显著增加(P<0.05)。术后第1 d、1个月经皮组VAS评分显著低于开放组(P<0.05)。术后相应时间点,经皮组Majeed评分均显著高于开放组(P<0.05)。影像方面,两组间骨折复位Matta评级和骨折愈合时间的差异均无统计学意义(P>0.05)。[结论]经皮空心钉固定骶髂关节脱位合并耻骨支骨折可减少手术创伤,并有利于患者术后功能康复。[Objective] To explore the clinical outcomes of percutaneous cannulated screw for sacroiliac dislocation combined with pubic fracture. [Methods] From January 2014 to December 2018, 35 patients underwent surgical treatment for sacroiliac dislocation combined with pubic fracture. Of them, 14 patients received percutaneous screw fixation, while the remaining 21 patients had open internal fixation through ilioinguinal approach. The perioperative, follow-up and radiographic documents were compared between the two groups. [Results] The percutaneous group proved significantly superior to the open group regarding to intraoperative blood loss and operation time(P<0.05), as well as occurrence of early complications(P<0.05). As time went, the VAS score significantly decreased, whereas Majeed score significantly increased in both groups(P<0.05). The percutaneous group had significantly lower VAS score than the open group at 1 day and 1 month after operation(P<0.05),whereas the former got significantly higher Majeed score than the latter at all time points postoperatively(P<0.05). In term of imaging evaluation, there were no statistically significant differences in Matta scale for fracture reduction, and bony healing time of the fractures between the two groups(P>0.05). [Conclusion] For sacroiliac dislocation combined with pubic fracture, the percutaneous cannulated screw does reduce iatrogenic trauma and improve functional recovery compared with open internal fixation.

关 键 词：骨盆骨折 骶髂关节脱位 耻骨骨折 经皮内固定 开放内固定 

分 类 号：R683.3[医药卫生—骨科学]