前皮下内固定支架与钢板内固定治疗不稳定型骨盆前环骨折疗效比较  

Comparison of effectiveness of anterior subcutaneous internal fixator and plate internal fixation for unstable anterior pelvic ring fractures

作　　者：于潇 王强[3] 马勇[1,2] 邱俊骏 赵磊[3] 隋吉生[3] 倪艳 YU Xiao;WANG Qiang;MAYong;QIU Junjun;ZHAO Lei;SUI Jisheng;NI Yan(Institute of Traumatology&Orthopedics,Nanjing University of Chinese Medicine,Nanjing Jiangsu,210023,P.R.China;Laboratory of New Techniques of Restoration&Reconstruction of Orthopedics and Traumatology,Nanjing University of Chinese Medicine,Nanjing Jiangsu,210023,P.R.China;Department of Orthopedics,Nanjing Medical University(Nanjing First Hospital),Nanjing Jiangsu,210000,P.R.China)

机构地区：[1]南京中医药大学骨伤研究所,南京210023 [2]南京中医药大学骨伤修复与重建新技术实验室,南京210023 [3]南京医科大学附属南京医院(南京市第一医院)骨科,南京210000

出　　处：《中国修复重建外科杂志》2020年第12期1555-1560,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的比较前皮下内固定支架(anterior subcutaneous internal fixator,INFIX)和钢板内固定治疗不稳定型骨盆前环骨折的疗效。方法回顾分析2014年6月—2019年12月收治且符合选择标准的48例不稳定型骨盆前环骨折患者临床资料,其中INFIX内固定21例(INFIX组),钢板内固定27例(钢板组)。两组患者性别、年龄、体质量指数、致伤原因、受伤至手术时间、创伤严重程度评分(ISS)以及骨折类型等一般资料比较,差异均无统计学意义(P>0.05)。记录并比较两组手术时间、术中出血量、骨折愈合时间以及患者部分负重、完全负重时间。采用Matta标准评价骨折复位质量,Majeed评分系统评价骨盆骨折术后功能恢复情况。结果两组患者均获随访,随访时间6~16个月,平均12.5个月。INFIX组手术时间及术中出血量均明显低于钢板组(t=-11.965,P=0.000;t=-20.105,P=0.000)。术后两组骨折复位质量、骨折愈合时间、部分负重时间及完全负重时间比较,差异均无统计学意义(P>0.05)。术后14周,INFIX组与钢板组Majeed评分中疼痛、工作、立位及行走、总分比较,差异均无统计学意义(P>0.05);坐位及性生活评分差异有统计学意义(t=-4.250,P=0.003;t=-6.135,P=0.006)。INFIX组股外侧皮神经损伤、股神经损伤及异位骨化发生率明显高于钢板组,切口感染发生率明显低于钢板组,差异均有统计学意义(P<0.05)。结论INFIX内固定治疗不稳定型骨盆前环骨折可获得较好疗效,与钢板内固定相比,具有手术时间短、术中出血量少、感染风险较低等优点。Objective To compare the effectiveness of anterior subcutaneous pelvic internal fixator(INFIX)and plate internal fixation in treatment of unstable anterior pelvic ring fractures.Methods The clinical data of 48 patients with unstable anterior pelvic ring fractures who met the selection criteria between June 2014 and December 2019 were retrospectively analyzed.Among them,21 cases were treated with INFIX(INFIX group),and 27 cases were treated with plate(plate group).There was no significant difference in gender,age,body mass index,cause of injury,time from injury to operation,Injury Severity Score(ISS),and fracture type between the two groups(P>0.05).The operation time,intraoperative blood loss,fracture healing time,partial weight-bearing time,and complete weight-bearing time were recorded and compared between the two groups.Matta standard was used to evaluate the quality of fracture reduction,and Majeed score system was used to evaluate the functional recovery of pelvic fracture after operation.Results The patients in both groups were followed up for an average of 12.5 months(range,6-16 months).The operation time and intraoperative blood loss in INFIX group were significantly lower than those in plate group(t=-11.965,P=0.000;t=-20.105,P=0.000).There was no significant difference in the quality of fracture reduction,fracture healing time,partial weight-bearing time,and complete weight-bearing time between the two groups(P>0.05).At 14 weeks after operation,there was no significant difference in the scores of pain,working,standing and walking,and total scores between INFIX group and plate group(P>0.05),but there were significant differences in sitting and sexual intercourse scores(t=-4.250,P=0.003;t=-6.135,P=0.006).The incidences of lateral femoral cutaneous nerve injury,femoral nerve injury,and heterotopic ossification were significantly higher in INFIX group than in plate group(P<0.05),while the incidence of incision infection was lower in INFIX group than in plate group(P<0.05).Conclusion Compared with the plate in

关 键 词：骨盆前环骨折 不稳定型骨折 前皮下内固定支架 钢板 内固定 

分 类 号：R687.3[医药卫生—骨科学]