CAJ | 학술논문

回顾性分析2004-01/2007-04延安医院骨科收治的骨盆后环损伤患者36例,按照Denis分型,Ⅰ型20例,Ⅱ型12例,Ⅲ型4例;按照Tile分型,B3型16例,C1型10例,C2型6例,C3型4例.应用脊柱钉棒系统置入固定治疗,将万向椎弓根钉从双侧髂后上棘处开槽置入髂骨后部内外板间,钉尾沉于骨质内,连接棒通过双侧骶棘肌隧道放置固定后,在骨盆后环处形成一个强有力的"内支架"有效固定.30例获随访.随访6～18个月,平均11个月.患者均无螺钉松动、断棒、骶髂关节再次脱位及内固定物引起的血管、神经损伤并发症.根据功能评定标准,优15例,良13例,中2例.提示脊柱钉棒系统治疗骨盆后环损伤,无需复杂定位,置入固定有效牢靠,创伤小,恢复快,无透视条件的基层单位也可操作.
회고성분석2004-01/2007-04연안의원골과수치적골분후배손상환자36례,안조Denis분형,Ⅰ형20례,Ⅱ형12례,Ⅲ형4례;안조Tile분형,B3형16례,C1형10례,C2형6례,C3형4례.응용척주정봉계통치입고정치료,장만향추궁근정종쌍측가후상극처개조치입가골후부내외판간,정미침우골질내,련접봉통과쌍측저극기수도방치고정후,재골분후배처형성일개강유력적"내지가"유효고정.30례획수방.수방6～18개월,평균11개월.환자균무라정송동、단봉、저가관절재차탈위급내고정물인기적혈관、신경손상병발증.근거공능평정표준,우15례,량13례,중2례.제시척주정봉계통치료골분후배손상,무수복잡정위,치입고정유효뢰고,창상소,회복쾌,무투시조건적기층단위야가조작.
Abstract:The present case report retrospectively analyzed 36 cases of injury to posterior pelvic dng who received treatment in the Department of Orthopedics,Yan'an Hospital between January 2004 and April 2007. According to the Denis classification,there were 20 cases of type I injury to posterior pelvic ring,12 of type Ⅰ,and 4 of Ⅲtype Ⅲ; according to Tile classification,there were 16 cases of B3,10 of C1,6 of C2,and 4 of C3. Pedicle screw fixation system was employed. Two curvy incisions were made on the bilateral posterior superior lilac spine and a hole was chiseled on each side to fit the pedicle screw. Then,a universal pedicle screw was driven between the inner and outer lilac plates until the screw were sunk. A rod was finally traversed through erector spinae to connect two pedicle screws. Thirty cases were available at follow-up with a mean of 11 months (range:6-11 months). None of 30 cases presented with nerve or vessel injury and breakage,loosening of screws,or redislocation of sacroiliac joints. According to functional rating scale,excellent results were found in 15 cases,good in 13,and fair in 2 cases. These findings suggest that treatment for injury to posterior pelvic ring with pedicle screw fixation system is simple and reliable with microtrauma and little bleeding; in addition,it affords good recovery and can be employed in primary hospital without monitoring of X-ray,so it will deserve popular practice.