骨盆支架辅助复位联合通道螺钉固定治疗骨盆骨折  

Starr frame assisted reduction combined with channel screw fixation in the treatment of pelvic fractures

作　　者：杨家赵 谢凯[1] 李黎[1] 王叙进 徐磊[1] 夏睿 徐玮 方诗元 YANG Jia-zhao;XIE Kai;LI Li;WANG Xu-jin;XU Lei;XIA Rui;XU Wei;FANG Shi-yuan(Dept of Orthopaedics,the First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230001,China)

机构地区：[1]中国科学技术大学附属第一医院骨科,安徽合肥230001

出　　处：《临床骨科杂志》2021年第5期699-703,共5页Journal of Clinical Orthopaedics

基　　金：安徽省科技厅攻关计划项目(编号:1401045022);中国科学技术大学附属第一医院医疗领先技术项目(编号:2020LXJS)。

摘　　要：目的探讨骨盆支架(Starr架)辅助复位联合通道螺钉固定治疗骨盆骨折的临床疗效。方法采用Starr架辅助复位联合通道螺钉固定治疗22例骨盆骨折患者。记录螺钉使用情况、手术情况,采用Majeed评分评价骨盆功能。结果22例患者后环损伤均采用骶髂螺钉固定,其中使用单枚骶髂螺钉12例,2枚骶髂螺钉9例,3枚骶髂螺钉1例;前环损伤均采用经皮骨盆前环内固定(Infix固定),其中使用2枚椎弓根螺钉7例,3枚椎弓根螺钉13例,4枚椎弓根螺钉2例。手术时间75~250(137.0±43.7)min,术中出血量20~150(45.0±30.5)ml,透视时间13~59(24.3±11.2)s。患者均获得随访,时间6~20(12.5±5.7)个月。骨痂形成时间3~8(4.3±1.2)周。末次随访时,采用Majeed评分系统评价骨盆功能:优15例,良5例,可2例。术后并发症:1例内固定松动,2例大腿前外侧感觉异常,1例复位丢失后畸形愈合,1例骨不连,1例异位骨化。结论治疗骨盆骨折时,Starr架辅助复位可实现骨折解剖复位,联合通道螺钉固定技术可在伤后早期恢复骨盆环的稳定性,且相关并发症少,有利于患者功能康复。Objective To investigate the clinical effect of pelvic frame(Starr frame)assisted reduction combined with channel screw fixation for treatment of pelvic fracture.Methods The 22 patients with pelvic fractures were treated with Starr frame assisted reduction combined with channel screw fixation.The situation of screw use and operation were recorded,and Majeed score was used to evaluate the pelvic function.Results In the 22 patients,the posterior ring injuries were fixed with sacroiliac screws,including 12 cases with single sacroiliac screw,9 cases with 2 sacroiliac screws,and 1 case with 3 sacroiliac screws;the anterior ring injuries were all fixed with percutaneous anterior pelvic ring internal fixation(Infix fixation),including 7 cases with 2 pedicle screws,13 cases with 3 pedicle screws,and 2 cases of 4 pedicle screws.The operation time was 75~250(137.0±43.7)min,the intraoperative blood loss was 20~150(45.0±30.5)ml,the fluoroscopy time was 13~59(24.3±11.2)s.All patients were followed up for 6~20(12.5±5.7)months.The time of callus formation was 3~8(4.3±1.2)weeks.At the last follow-up,Majeed score was used for evaluation:15 cases were excellent,5 cases good,and 2 fair.Postoperative complications:1 case had internal fixation loose,and 2 cases had anterolateral thigh paresthesia,1 case had malunion after reduction loss,1 case was heterotopic ossification.Conclusions In the treatment of pelvic fractures,Starr frame assisted reduction can achieve anatomic reduction,and combined with channel screw fixation technique can restore the stability of the injured pelvic ring in early stage,with fewer complications,it is beneficial to the functional rehabilitation of patients.

关 键 词：骨盆骨折 骨盆支架 通道螺钉固定 

分 类 号：R683.3[医药卫生—骨科学] R687.32[医药卫生—外科学]