桥接组合与钢板固定不稳定型骨盆骨折的对比  

Comparison of clinical outcomes of bridge-link type combined fixation system versus locking plate for unstable pelvic fractures

作　　者：刘聪[1] 夏波[1] 王士进[1] 梁霞 王军[1] LIU Cong;XIA Bo;WANG Shi-jin;LIANG Xia;WANG Jun(Department of Traumatic Orthopaedics,Central Hospital ofTaian City,Taian 271000,China)

机构地区：[1]泰安市中心医院创伤外科,山东泰安271000

出　　处：《中国矫形外科杂志》2020年第24期2223-2226,共4页Orthopedic Journal of China

基　　金：泰安市科技发展计划项目(编号:2016NS1174)。

摘　　要：[目的]比较桥接组合式系统与锁定钢板治疗不稳定型骨盆骨折的临床效果。[方法] 2014年3月~2019年3月,本院对68例不稳定型骨盆骨折患者行手术治疗。其中,34例采用桥接组合式内固定,34例采用锁定钢板内固定。比较两组患者的围手术期、随访与影像资料。[结果]两组患者均顺利完成手术,未发生重要血管神经等损伤。桥接组在手术时间、术中出血量和切口长度均显著优于钢板组(P<0.05)。两组患者随访12个月以上,桥接组开始负重行走时间、完全负重行走时间显著早于钢板组(P<0.05)。末次随访时,两组间Harris评分与Majeed评分差异无统计学意义(P>0.05)。影像学方面,两组术后骨折复位满意,按Matta骨折复位标准,两组所有患者均为优。术后8周,桥接组34例中有3例骨折愈合不满意,而钢板组34例中有8例骨折愈合不满意。末次随访时,两组患者均达到骨性愈合,内固定未出现松动及断裂。[结论]桥接组合式内固定系统治疗不稳定型骨盆骨折的临床结果优于锁定钢板。[Objective] To compare clinical outcomes of bridge-link type combined fixation system(BCFS) versus locking plate for unstable pelvic fractures. [Methods] From march 2014 to march 2019, a total of 68 patients underwent open reduction and internal fixation(ORIF) for unstable pelvic fractures in our hospital. Of them, 34 patients received ORIF with BCFS, while34 patients had operation performed with locking plate. The two groups were compared regarding perioperative, follow-up and radiographic documents. [Results] All the patients in both groups had surgical interventions conducted successfully without iatrogenic injuries to nerves and blood vessels. The BCFS group proved significantly superior to the plate group regarding operation time, intraoperative blood loss and incision length(P<0.05). All the patients in both groups were followed up for more than12 months. The BCFS group returned to ambulation and full-weight bearing activity significantly earlier than the plate group(P<0.05), whereas there were no significant differences in Harris and Majeed scores between the two groups at the latest follow-up(P>0.05). With regard to radiographic assessment, all patients in both groups got satisfactory fracture reduction with the excellent grade based on Matta’s criteria. At 8 weeks postoperatively, improper fracture healing was noted on images in 3/34 patients of the BCFS group, whereas 8/34 patients of the plate group. To the latest follow up, all patients in both groups got fracture healing without implant loosening and breaking. [Conclusion] The BCFS is superior to locking plate for treatment of unstable pelvic fractures in clinical outcome in this study.

关 键 词：不稳定型骨盆骨折 桥接组合式内固定系统 锁定钢板 临床结果 

分 类 号：R683.3[医药卫生—骨科学]