腔隙闭合术辅助内固定一期治疗骨盆骨折合并Morel-Lavallee损伤的32例疗效观察  

Observation of curative effect of 32 cases of pelvic fractures complicated with Morel-Lavallee injury by one-stage lacunar closure and internal fixation

作　　者：雷金来[1] Lei Jinlai(Ring Pelvic Ward,Skeletal Trauma Hospital,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学附属红会医院骨创伤医院环骨盆病区,710054

出　　处：《美中国际创伤杂志》2022年第1期37-41,共5页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨腔隙闭合术辅助内固定--期治疗骨盆骨折合并皮肤剥脱(Morel-lavalle soft issue le-sion,MLLs)的临床疗效。方法:对我院我科2017年7月至2019年7月收治的骨盆骨折合并MILLs的32例患者进行回顾性分析,骨盆骨折均行切开复位内固定,并联合腔隙闭合术治疗MLLs损伤,创面持续负压吸引5-7d后拆除或更换负压引流装置,术后定期随访观察伤口愈合情况,并采用Majeed功能评分对骨盆骨折术后功能进行系统评价。结果:患者住院时间14-28d,平均19.2d.32例均获随访,随访时间4-18个月,平均8.6个月。有23例患者行1次腔隙闭合术后MLLs区域伤口获得愈合,皮肤成活良好,无切口及骨感染、皮肤软组织坏死、复发性假性滑囊形成等并发症;4例患者术后行2次腔隙闭合术后MLLs区域伤口获得愈合:3例患者MLLs区域伤口愈合后周围皮肤浅感觉减退;1例患者MLLs区域伤口脂肪液化,1例患者MLLs区域伤口见少量分泌物,细菌培养无阳性发现,以上2例患者经对症处理,伤口均获痊愈。X线片复查示骨折均愈合,愈合时间10-19w,平均14.2w。术后6.8个月,32例骨盆骨折按Majeed疗效评分为65-100分,平均84.5分。结论:对于骨盆骨折合并Morel-Lavallee损伤,内固定治疗骨折同时联合腔隙闭合术治疗Morel-Lavalle损伤,既能有效治疗Morel-lavallee损伤,又能保障骨盆骨折的手术安全,减少感染,获得满意的临床疗效。Objective:To explore the clinical efficacy of lacunar closure assisted with internal fixation in the treatment of pelvic fractures with skin-exfoliation injuries(Morel-Lavallee soft tissue lesions,MLLs).Methods:A retrospective analysis of 32 cases of pelvic fracture with MLLs admitted in our hospital from July 2017 to July 2019 was carried out.Pelvic fractures were treated with open reduction and internal fixation combined with lacunar closure for MLLs injury.The negative pressure drainage device was removed or replaced after continuous negative pressure suction of the wound for 5-7 days.The wound healing was observed at regular follow-up after operation.Majeed functional score was used to systematically evaluate the postoperative function of pelvic fractures.Results:The patient's hospital stay was 14-28 days,with an average of 19.2 days.All 32 cases were followed up for 4-18 months,with an average of 8.6 months.In 23 patients,the wounds in the MLLs area were healed after one lacunar closure,the skin survived well,and there were no complications such as incision and bone infection,skin and soft tissue necrosis,and recurrent pseudobursae formation.The wounds in the MLLs area were healed after 2 times of lacunar closure in 4 patients and the superficial feeling of the surrounding skin decreased after the wounds in the MLLs area healed in 3 patients.The wound in the MLLs area,fat liquefaction noted in 1 patient and small amount of secretions noted in 1 patient respectively,no positive bacterial culture found,the wounds of the above 2 patients were cured after symptomatic treatment.X-ray review showed that all fractures healed,and the healing time was 10-19w,with an average of 14.2w.At 6.8 months after operation,32 cases of pelvic fractures were scored as 65-100 points according to Majeed efficacy score,with an average score of 84.5 points.Conclusion:For cases of pelvic fracture with Morel-Lavallee injury,internal fixation for fractures combine with lacunar closure can not only effectively treat Morel-Lavallee injury

关 键 词：骨盆骨折 Morel-Lavallee损伤 腔隙闭合术 内固定 

分 类 号：R68[医药卫生—骨科学]