钉棒内固定支架治疗骨盆前环骨折27例  

Treatment of 27 Cases of Anterior Pelvic Ring Fracture with Anterior Subcutaneous Internal Fixator

作　　者：田义军 郭浩山 李楠 TIAN Yijun;GUO Haoshan;LI Nan(Department of Orthopaedic,Liaocheng Hospital of Traditional Chinese Medicine,Liaocheng 252000,Shandong China)

机构地区：[1]聊城市中医医院骨科,山东聊城252000

出　　处：《中国中医骨伤科杂志》2023年第9期67-70,74,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：山东省医药卫生科技发展计划项目(202204070834)。

摘　　要：目的:探讨钉棒系统前皮下内固定支架(INFIX)治疗骨盆前环骨折的效果。方法:自2015年10月至2022年6月采用内固定支架技术治疗骨盆前环骨折患者27例:其中男17例,女10例;年龄中位数为43岁;受伤至手术时间平均为3.2 d。Tile分型:B1型6例,B2型11例,B3型6例,C1型4例。采用内固定支架技术对骨盆前环骨折进行复位内固定,合并后环不稳定者给予骶髂关节螺钉固定。记录手术时间、术中出血量、术中及术后并发症情况,观察骨折复位效果及术后骨盆功能恢复情况。结果:所有病例均获随访,随访时间为5~16个月,中位数为11个月;手术时间为(61.43±8.92)min,术中出血量为(55.40±10.64)mL。1例1侧切口出现延迟愈合,6例8侧切口出现股外侧皮神经刺激症状,3例术后出现小腿肌静脉血栓。术后根据Matta骨折复位标准评价:优14例,良10例,中3例,优良率为88.9%。末次随访时Majeed评分为(86.52±11.73)分,其中优17例,良8例,可2例,优良率为92.6%。结论:内固定支架技术治疗不稳定性骨盆前环损伤,具有创伤小、操作便捷、固定可靠、便于护理、活动自由等优点,值得临床推广应用,同时应重视股外侧皮神经损伤等并发症的防范。Objective:To investigate the efficacy of anterior subcutaneous internal fixator(INFIX)on the treatment of anterior pelvic ring fractures.Methods:27 patients with anterior pelvic ring fracture were treated with INFIX from October 2015 to June 2022,including 17 males and 10 females,with an median age of 43 years old and an average of 3.2 days from injury to surgery.Tile classification:6 cases of type B1,11 cases of type B2,6 cases of type B3,4 cases of type C1.The INFIX was used for reduction and internal fixation of anterior pelvic ring fractures,and the patients with unstable posterior ring were fixed with sacroiliac joint screws.The operation time,intraoperative blood loss,intraoperative and postoperative complications were recorded,and the efficacy of fracture reduction and postoperative pelvic function recovery were observed.Results:All cases were followed up for 516 months(average 11 months).The operation time was(61.43±8.92)min,and the intraoperative blood loss was(55.40±10.64)mL.Delayed healing occurred in 1 side incision in 1 case,lateral femoral cutaneous nerve irritation occurred in 8 side incision in 6 cases,and calf muscle vein thrombosis occurred in 3 cases.14 cases were excellent,10 cases were good,and 3 cases were fair.The excellent and good rate was 88.9%according to Matta's fracture reduction criteria.At the last follow-up,the Majeed score was(86.52±11.73)points,of which 17 cases were excellent,8 cases were good,and 2 cases were fair.The excellent and good rate was 92.6%.Conclusion:The INFIX for the treatment of unstable anterior pelvic ring injury has the advantages of less trauma,convenient operation,reliable fixation,convenient care,and freedom of movement.It is worthy of clinical promotion.At the same time,attention should be paid to the prevention of compli-cations such as lateral femoral cutaneous nerve injury.

关 键 词：钉棒系统 内固定支架 骨盆骨折 骨盆前环损伤 

分 类 号：R683.3[医药卫生—骨科学]