计算机模拟复位联合骨盆复位架治疗APC-Ⅲ型骨盆骨折  

Computer-simulated repositioning combined with pelvic reduction frame for treatment of anteroposterior compression-III pelvic fractures

作　　者：高振洋 曾秀安 杨其兵 寇贤帅 王克竞 厉孟 Gao Zhenyang;Zeng Xiuan;Yang Qibing;Kou Xianshuai;Wang Kejing;Li Meng(First Clinical College of Medicine,Gansu University of Chinese Medicine,Lanzhou 730030,Gansu Province,China;Baiyun Hospital Affiliated to Guizhou Medical University,Guiyang 550014,Guizhou Province,China;Gansu Cancer Hospital,Lanzhou 730050,Gansu Province,China;Gansu Provincial People’s Hospital,Lanzhou 730030,Gansu Province,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃省兰州市730030 [2]贵州医科大学附属白云医院,贵州省贵阳市550014 [3]甘肃省肿瘤医院,甘肃省兰州市730050 [4]甘肃省人民医院,甘肃省兰州市730030

出　　处：《中国组织工程研究》2025年第9期1870-1875,共6页Chinese Journal of Tissue Engineering Research

基　　金：甘肃省人民医院优秀硕士生培育计划项目(22GSSYD-47),项目负责人:寇贤帅;甘肃中医药大学研究生“创新之星”项目(2023CXZX-756),项目负责人:寇贤帅。

摘　　要：背景:骨盆骨折类型多样,使用骨盆复位架进行复位时缺乏系统的复位路径,需要根据术者经验结合透视结果进行调整,具有不确定性与不可重复性。目的:探讨计算机模拟复位技术联合骨盆复位架治疗前后压缩(anteroposterior compression,APC)-Ⅲ型骨盆骨折的临床疗效。方法:回顾性分析2018年1月至2021年12月术前采用计算机模拟复位,术中采用骨盆复位架辅助复位的APC-Ⅲ型骨盆骨折患者19例,其中7例使用前环双钢板、12例采用单钢板联合前环皮下内置外固定架固定,所有患者均使用2枚骶髂螺钉固定后环。记录手术时间、术中复位时间、术中透视次数、出血量和随访时间,观察骨折愈合时间及术后并发症情况。根据Matta评分标准评定骨折复位情况,末次随访采用Majeed骨盆功能评分评估患者功能。结果与结论:①19例患者均完成手术,7例前环使用双钢板、12例采用单钢板联合前环皮下内置外固定架固定,后环均使用2枚骶髂螺钉,分别固定S1、S2椎体;②手术时间74-147 min,平均(101.63±19.55)min;术中复位时间26-41 min,平均(38.11±3.31)min;术中透视次数35-81次,平均(62.68±13.11)次;术中出血60-130 mL,平均(85.37±20.57)mL;③所有患者均获得随访,随访时间12-26个月,骨折愈合时间12-20周,平均(16.37±2.50)周;④术后1 d按Matta标准评定复位情况:优14例,良5例;末次随访Majeed功能评分:优16例,良3例;⑤2例患者术区切口出现红肿、渗液等脂肪液化现象,经积极换药后逐渐愈合;所有患者术后均未出现内固定物松动、骨折复位丢失、神经损伤等并发症。提示采用计算机模拟复位技术联合骨盆复位架治疗APC-Ⅲ型骨盆骨折,在提高复位效率、改善骨盆功能方面均具有优势。BACKGROUND:Pelvic fractures encompass a range of types,and the utilization of a pelvic reduction frame for restoration often lacks a systematic repositioning method.Instead,it relies on the operator’s experience in conjunction with fluoroscopic findings,which can lead to uncertainty and non-reproducibility.OBJECTIVE:To investigate the clinical efficacy of combining computer-simulated repositioning techniques with a pelvic reduction frame for the treatment of anteroposterior compression-III pelvic fractures.METHODS:A retrospective analysis was conducted on 19 patients with anteroposterior compression-III pelvic fractures who underwent preoperative repositioning via computer simulation and intraoperative repositioning with the assistance of a pelvic reduction frame between January 2018 and December 2021.Among them,7 cases were fixed with double plate in anterior ring and 12 cases were fixed with single plate combined with anterior subcutaneous internal fixation(INFIX).All patients received posterior ring fixation with two sacroiliac screws.Operative duration,intraoperative reduction time,the frequency of intraoperative fluoroscopy use,blood loss,and follow-up duration were documented.These data were utilized to monitor fracture healing time and postoperative complications.Fracture reduction quality was evaluated according to the Matta scale,and the Majeed Pelvic Function Score was employed to assess patient function during the final follow-up.RESULTS AND CONCLUSION:(1)Surgery was successfully completed in all 19 patients.The anterior ring was secured with double plates in 7 cases,while a single plate combined with INFIX was utilized in 12 cases.The posterior ring was stabilized with two sacroiliac screws,specifically targeting the S1 and S2 cones.(2)The operation duration ranged from 74 to 147 minutes,with a mean of(101.63±19.55)minutes.Intraoperative repositioning took place over a period of 26 to 41 minutes,with a mean of(38.11±3.31)minutes.The number of intraoperative fluoroscopies conducted ranged from 35 t

关 键 词：骨盆骨折 前后压缩型损伤 闭合复位 骨盆解锁复位装置 钢板 内固定 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R683.3