中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2011年
11期
1191-1196
,共6页
宋世锋%彭磊%肖海涛%郑南生%陈世强%马业涛%张熙民%林坚平%曾凡%姚理阳
宋世鋒%彭磊%肖海濤%鄭南生%陳世彊%馬業濤%張熙民%林堅平%曾凡%姚理暘
송세봉%팽뢰%초해도%정남생%진세강%마업도%장희민%림견평%증범%요리양
骨盆%髋骨折%骨折固定术,内%治疗结果
骨盆%髖骨摺%骨摺固定術,內%治療結果
골분%관골절%골절고정술,내%치료결과
Pelvis%Hip fractures%Fracture fixation,internal%Treatment outcome
目的 比较骨盆骨折合并骶髂关节脱位经皮空心螺钉内固定与切开复位重建钢板内固定治疗的临床疗效,并评价其安全性和实用性.方法 2004年3月至2010年10月,收治37例不稳定性骨盆骨折.在“C”型臂X线机引导下,20例患者接受经皮骶髂关节螺钉内固定,17例患者接受切开复位重建钢板内固定,比较和分析两组的围手术期参数和术后影像学指标.结果 对全部病例随访6～26个月,平均15个月.经皮螺钉组与切开钢板组在手术时间、术中出血量、术后疼痛程度、术后平均发热时间和住院时间等方面比较差异均有统计学意义,两组根据术后X线评价的复位效果差异无统计学意义.骨折平均愈合时间:经皮螺钉组为3.2个月,切开钢板组为3.6个月,两组差异无统计学意义.经皮螺钉组无感染、弯钉及断钉等并发症发生.结论 经皮骶髂空心螺钉内固定术治疗骨盆骨折具有定位准确、损伤小、出血少、疼痛轻、恢复快等优点,是一种理想的微创手术方法,前后环固定适用于骨折及脱位不明显者；该术式对术者操作技术要求较高,充分的术前准备及患者术后配合能减少并发症发生.重建钢板或桡骨远端“T”形钢板可用于固定垂直不稳定性骨盆骨折.
目的 比較骨盆骨摺閤併骶髂關節脫位經皮空心螺釘內固定與切開複位重建鋼闆內固定治療的臨床療效,併評價其安全性和實用性.方法 2004年3月至2010年10月,收治37例不穩定性骨盆骨摺.在“C”型臂X線機引導下,20例患者接受經皮骶髂關節螺釘內固定,17例患者接受切開複位重建鋼闆內固定,比較和分析兩組的圍手術期參數和術後影像學指標.結果 對全部病例隨訪6～26箇月,平均15箇月.經皮螺釘組與切開鋼闆組在手術時間、術中齣血量、術後疼痛程度、術後平均髮熱時間和住院時間等方麵比較差異均有統計學意義,兩組根據術後X線評價的複位效果差異無統計學意義.骨摺平均愈閤時間:經皮螺釘組為3.2箇月,切開鋼闆組為3.6箇月,兩組差異無統計學意義.經皮螺釘組無感染、彎釘及斷釘等併髮癥髮生.結論 經皮骶髂空心螺釘內固定術治療骨盆骨摺具有定位準確、損傷小、齣血少、疼痛輕、恢複快等優點,是一種理想的微創手術方法,前後環固定適用于骨摺及脫位不明顯者；該術式對術者操作技術要求較高,充分的術前準備及患者術後配閤能減少併髮癥髮生.重建鋼闆或橈骨遠耑“T”形鋼闆可用于固定垂直不穩定性骨盆骨摺.
목적 비교골분골절합병저가관절탈위경피공심라정내고정여절개복위중건강판내고정치료적림상료효,병평개기안전성화실용성.방법 2004년3월지2010년10월,수치37례불은정성골분골절.재“C”형비X선궤인도하,20례환자접수경피저가관절라정내고정,17례환자접수절개복위중건강판내고정,비교화분석량조적위수술기삼수화술후영상학지표.결과 대전부병례수방6～26개월,평균15개월.경피라정조여절개강판조재수술시간、술중출혈량、술후동통정도、술후평균발열시간화주원시간등방면비교차이균유통계학의의,량조근거술후X선평개적복위효과차이무통계학의의.골절평균유합시간:경피라정조위3.2개월,절개강판조위3.6개월,량조차이무통계학의의.경피라정조무감염、만정급단정등병발증발생.결론 경피저가공심라정내고정술치료골분골절구유정위준학、손상소、출혈소、동통경、회복쾌등우점,시일충이상적미창수술방법,전후배고정괄용우골절급탈위불명현자；해술식대술자조작기술요구교고,충분적술전준비급환자술후배합능감소병발증발생.중건강판혹뇨골원단“T”형강판가용우고정수직불은정성골분골절.
Objective To compare the clinical effect of percutaneous iliosacral screws osteosynthesis (PISO) and open reduction internal reconstruction plate fixation in treating unstable pelvic fractures combined with sacroiliac joint dislocation,and evaluate their safety and practicality.Methods From March 2004 to October 2010,37 patients with vertical unstable pelvic fractures were admitted to our department.Twenty cases were treated with percutaneous sacroiliac screw fixation and 17 cases were performed opened reduction and internal reconstruction plate fixation under C-arm X-ray's guide.The perioperative parameters and postoperative imaging indexes were compared and analyzed.Results All patients were followed up for 6 months to 26 months,with an average of 15 months.There were statistical significances between the PISO group and open reduction internal fixation group in operation time,blood loss,postoperative pain,mean fever time and hospital stay.The two groups showed no significant difference on postoperative X-evaluation of reduction effect.The average healing time was 3.2 months and the difference was not statistically significant between two groups.PISO group had no complications such as infection,bent nails or broken nails.Conclusion Through compared and analyzed the two groups in treating unstable pelvic fractures,the percutaneous sacroiliac screw fixation has been proved for a kind of ideal minimally invasive surgery method because of locating exactly,less damage and blood loss,milder pain and quicker recovery.But it demands higher operation techniques.Adequate preoperative preparation and postoperative patients' cooperation can reduce complications incidence.The second group of anterior reconstruction plate or T-shape plate to fix vertically unstable pelvic fractures at same time shows a good result of stabilization.
