中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2008年
12期
1013-1018
,共6页
桑锡光%张立平%李牧%刘海春
桑錫光%張立平%李牧%劉海春
상석광%장립평%리목%류해춘
脊柱骨折%骶骨%腰椎-髂骨固定
脊柱骨摺%骶骨%腰椎-髂骨固定
척주골절%저골%요추-가골고정
Spinal fractures%Sacrum%Lumbo-iliac fixation
目的 观察研究髂骨后柱的解剖形态及腰椎-髂骨固定术在Denis Ⅲ区粉碎性骶骨骨折后骨盆环重建中的应用价值.方法 用17具尸体骨和干燥骨对髂骨后柱的形态、特征进行观察,测量髂骨后柱的长度、宽度、安全高度及标准高度,描述髂骨钉的进针点及操作方法.选择9例累及DenisⅢ区的粉碎性骶骨骨折合并神经损伤患者,在减压的同时采用腰椎-髂骨固定技术进行骨盆环重建.术后进行随访,对腰椎-髂骨固定技术的作用及神经康复的结果进行分析.结果 髂骨后柱平均长110.57 mm,宽24.24 mm;标准高度14.54 mm,安全高度31.46 mm.使用固定技术的9例患者术后可即刻行翻身活动,8例进行了13～37个月的随访,重建的骨盆环稳定,坐卧行功能良好,植骨融合,达到保持患肢功能和骨盆稳定性的目的 .结论 髂骨后柱为腰椎-髂骨固定技术提供可靠的解剖基础,在骶骨骨折合并前盆环破裂需要神经减压和固定时,该技术可提供牢固的内固定,对骨盆环重建、术后护理和康复有积极意义.
目的 觀察研究髂骨後柱的解剖形態及腰椎-髂骨固定術在Denis Ⅲ區粉碎性骶骨骨摺後骨盆環重建中的應用價值.方法 用17具尸體骨和榦燥骨對髂骨後柱的形態、特徵進行觀察,測量髂骨後柱的長度、寬度、安全高度及標準高度,描述髂骨釘的進針點及操作方法.選擇9例纍及DenisⅢ區的粉碎性骶骨骨摺閤併神經損傷患者,在減壓的同時採用腰椎-髂骨固定技術進行骨盆環重建.術後進行隨訪,對腰椎-髂骨固定技術的作用及神經康複的結果進行分析.結果 髂骨後柱平均長110.57 mm,寬24.24 mm;標準高度14.54 mm,安全高度31.46 mm.使用固定技術的9例患者術後可即刻行翻身活動,8例進行瞭13～37箇月的隨訪,重建的骨盆環穩定,坐臥行功能良好,植骨融閤,達到保持患肢功能和骨盆穩定性的目的 .結論 髂骨後柱為腰椎-髂骨固定技術提供可靠的解剖基礎,在骶骨骨摺閤併前盆環破裂需要神經減壓和固定時,該技術可提供牢固的內固定,對骨盆環重建、術後護理和康複有積極意義.
목적 관찰연구가골후주적해부형태급요추-가골고정술재Denis Ⅲ구분쇄성저골골절후골분배중건중적응용개치.방법 용17구시체골화간조골대가골후주적형태、특정진행관찰,측량가골후주적장도、관도、안전고도급표준고도,묘술가골정적진침점급조작방법.선택9례루급DenisⅢ구적분쇄성저골골절합병신경손상환자,재감압적동시채용요추-가골고정기술진행골분배중건.술후진행수방,대요추-가골고정기술적작용급신경강복적결과진행분석.결과 가골후주평균장110.57 mm,관24.24 mm;표준고도14.54 mm,안전고도31.46 mm.사용고정기술적9례환자술후가즉각행번신활동,8례진행료13～37개월적수방,중건적골분배은정,좌와행공능량호,식골융합,체도보지환지공능화골분은정성적목적 .결론 가골후주위요추-가골고정기술제공가고적해부기출,재저골골절합병전분배파렬수요신경감압화고정시,해기술가제공뢰고적내고정,대골분배중건、술후호리화강복유적겁의의.
Objective To study the anatomic morphology of posterior column of ilium(PCI)and valne of lumbo-iliac fixation(LIF)in pelvic ring reconstruction following communited Denis Ⅲ sacral fractures.Methods A total of 17 hemi-sectional pelvis and dry ilia were selected to observe the length,width and height(safety and standard)of PCI,when a detailed description was done on the methods determining entry point and operation techniqus for iliac screws anchoring.Nine patients with eommunited sacral fractures involving Denis Ⅲ areas combined with neurologic deficits were decompressed for recovery of neurological function and reconstruction of pelvic ring by using LIF.Postoperative follow-up was done on role of LIF and result of neural rehabilitation.Results PCI was mean 110.57 mm in length,24.24 mm in width,14.54 mm in standard height and 31.46 mm in safe height.Nine patients could turn over in bed immediately following operation and walk one month later.A follow-up for 13-37 months in eight patients showed stable reconstructed pelvic ring,sound function of movement and bone graft fusion,which met the target of keeping stability of fractured extremity and pelvis.Conclusions pCI can provide anatomic support for LIF.When decompression and fixation is needed for sacral fractures combined with anterior pelvic ring disruptions,LIP can provide stable fixation and play an important role in reconstruction,nursing and rehabilitation of pelvic ring.
