两种内固定治疗骨盆前环骨折的疗效比较  

Comparison efficacy of two kinds of internal fixation for pelvic anterior ring fractures

作　　者：徐练 林旭[1] 吴超[1] 谭伦[1] 钟泽莅[1] 曾俊[1] 胡海刚[1] XU Lian;LIN Xu;WU Chao;TAN Lun;ZHONG Ze-li;ZENG Jun;HU Hai-gang(Orthopaedics Center,the Fourth People′s Hospital of Zigong City,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：《临床骨科杂志》2024年第3期390-394,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较经皮空心螺钉内固定与皮下钉棒系统内固定(INFIX)治疗骨盆前环骨折的疗效。方法将43例骨盆前环骨折患者根据内固定方式不同分为经皮空心螺钉组(19例)和INFIX组(24例)。记录手术时间、术中出血量、术中透视次数、术后下地时间、骨折复位质量、骨折愈合时间以及并发症发生情况,采用Matta影像学标准评价骨折复位质量,采用Majeed评分系统评价临床疗效。结果患者均获得随访,时间12~24个月。手术时间、术后下地时间、骨折复位质量优良率、骨折愈合时间两组比较差异均无统计学意义(P>0.05)。术中出血量经皮空心螺钉组少于INFIX组(P<0.05)。术中透视次数经皮空心螺钉组多于INFIX组(P<0.05)。并发症发生率经皮空心螺钉组低于INFIX组(P<0.05)。末次随访时,两组疗效优良率比较差异无统计学意义(P>0.05)。结论采用经皮空心螺钉内固定与INFIX治疗骨盆前环骨折临床疗效相当,经皮空心螺钉内固定具有术中出血量少、并发症发生率低的优点,但存在术中透视次数较多的不足。Objective To compare the efficacy of percutaneous cannulated screw and subcutaneous screw-rod system internal fixation(INFIX)in the treatment of pelvic anterior ring fractures.Methods The 43 patients with unstable pelvic fractures were divided into the percutaneous cannulated screw group(19 cases)and INFIX group(24 cases),according to different internal fixation methods.The operative time,intraoperative blood loss,intraoperative fluoroscopy frequency,time to postoperative standing,quality of fracture reduction,fracture healing time,and the occurrence of complications were recorded.The quality of fracture reduction was evaluated by Matta imaging criteria,and the clinical outcomes were evaluated by Majeed scoring system.Results The patients were all followed up for 12~24 months.There were no statistical differences in terms of operative time,time to postoperative landing,the excellent-good rate of fracture reduction quality,fracture healing time between the two groups(P>0.05).The intraoperative blood loss in the percutaneous cannulated screw group was lower than that in the INFIX group(P<0.05).The frequency of intraoperative fluoroscopy in the percutaneous cannulated screw group was more than that in the INFIX group(P<0.05).In addition,the rate of complications incidence of the percutaneous cannulated screw group was lower than the INFIX group(P<0.05).At the last follow-up,there was no statistical difference in the comparison of efficacy excellent-good rate between the two groups(P>0.05).Conclusions In the treatment of anterior pelvic ring fracture,the clinical efficacy of percutaneous cannulated screw fixation is similar to that of INFIX.The percutaneous cannulated screw internal fixation has the advantages of less bleeding loss and lower incidence rate of complications,while it also has the disadvantages such as more intraoperative fluoroscopy frequency.

关 键 词：骨盆前环骨折 微创手术 经皮空心螺钉 经皮钉棒系统 

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