应用前环皮下内固定支架治疗骨盆前环骨折的近期临床疗效  

Short-Term Clinical Efficacy of INFIX in the Treatment of Anterior Pelvic Ring Fractures

作　　者：徐练 林旭[1] 谭伦[1] 吴超[1] 钟泽莅[1] 曾俊[1] 胡海刚[1] Xu Lian;Lin Xu;Tan Lun(Department of Orthopedics Center,Zigong Fourth People′s Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院骨科中心,四川自贡643000

出　　处：《四川医学》2023年第3期285-290,共6页Sichuan Medical Journal

摘　　要：目的 探讨骨盆前环皮下内固定支架(INFIX)治疗骨盆前环骨折的近期临床应用效果。方法 回顾性分析2018年1月至2021年8月我院收治且采用INFIX技术治疗的72例骨盆前环骨折患者的临床资料。其中男34例,女38例;年龄15~79岁,平均53.7岁;致伤原因:车祸伤43例,高坠伤19例,摔伤5例,重物砸伤5例。骨盆骨折Tile分型:Tile B型57例(B1型6例、B2型29例、B3型22例),Tile C型15例(C1型7例、C2型8例)。记录手术时间、术中出血量、随访时间、术后并发症、骨折愈合情况、末次随访时采用Matta影像学标准评价骨折复位质量,Majeed评分系统评价临床功能恢复情况。结果 所有患者顺利完成手术,手术时间20~85 min,平均(45.8±15.2)min;术中出血量5~50 ml,平均(19.3±10.2)ml。所有患者均获得随访,随访时间6~48个月,平均22.5个月。所有患者骨折均愈合,愈合时间8~20周,平均12.7周。其中4例发生畸形愈合;15例出现股外侧皮神经损伤表现(7例经对症处理后自行恢复,6例取出内固定后恢复,2例末次随访时仍残留少许症状);1例麻醉恢复后出现单侧股神经麻痹症状,立即调整内固定位置后恢复正常;3例术后感染(2例伤口浅层感染,经加强换药等对症处理后治愈;1例发生深部感染,经清创及加强抗感染等处理后治愈);5例异位骨化;6例下肢深静脉血栓形成;1例内固定无菌性松动。末次随访时:Matta评价骨折复位质量,优良率97.2%(其中,优59例,良11例,可2例);Majeed临床功能评分结果为67~99分,平均(85.2±6.9)分,优43例,良25例,可4例,优良率94.6%。结论 INFIX治疗骨盆前环骨折近期疗效满意,且具有手术操作简单,创伤小,固定牢靠,外观影响小,感染风险低等优点,但发生股外侧皮神经损伤等风险相对较高,需值得注意。Objective To investigate the short-term clinical efficacy of anterior subcutaneous internal fixator(INFIX)in the treatment of anterior pelvic ring fractures.Methods From January 2018 to August 2021,clinical data of 72 patients who were treated with INFIX for anterior pelvic ring fractures in our hospital were retrospectively analyzed.There were 34 males and 38 females who aged from 15 to 79 years(average 53.7 years).There were 43 cases of traffic accident injury,19 cases of high fall injury,5 cases of fall down injury,and 5 cases of crush injuries.According to Tile classification,there were 57 cases of Tile B type(6 cases of B1 type,29 cases of B2 type,22 cases of B3 type),15 cases of Tile C type(7 cases of C1 type,8 cases of C2 type).The operation time,intraoperative blood loss,follow-up period,postoperative complications,and fracture healing status were recorded.Quality of pelvic fracture reduction was evaluated by Matta scoring system,and Majeed score was used to evaluate clinical functional recovery at the last follow-up.Results All patients completed operation successfully.The operation time was 20~85 minutes,with an average of(45.8±15.2)minutes.The intraoperative blood loss was 5~50 ml,with an average of(19.3±10.2)ml.All patients were followed up for 6~48 months,with an average of 22.5 months.All fractures healed,and the healing time was 8 to 20 weeks,with an average of 12.7 weeks.Among them,4 cases had malunion.Lateral femoral cutaneous nerve injury was found in 15 cases(7 cases recovered spontaneously after symptomatic treatment,6 cases recovered after removal of internal fixation,and 2 cases still had few symptoms at the last follow-up).1 case occurred unilateral femoral nerve palsy after recovery from anesthesia,and returned to normal immediately after adjusting the position of internal fixation.There were 3 cases of postoperative infection(2 cases of superficial wound infection were cured after intensive dressing change and other symptomatic treatment,1 case developed deep infection,which was cured a

关 键 词：骨盆骨折 微创手术 前环皮下内固定支架(INFIX) 并发症 股外侧皮神经 

分 类 号：R683.3[医药卫生—骨科学]