CAJ | 학술논문

目的探讨外固定支架在骨盆骨折治疗中的作用和优点. 方法 2002年4月至2008年7月根据Tile分型,分别采用外固定支架固定、牵引+外固定支架固定、内固定+外支架同定三种方法对55例骨盆骨折进行复位固定,以达到骨折复位、骨盆环稳定的目的 . 结果 2例合并有胸腹部多发伤患者术后死亡,2例失访,51例获得平均11个月随访.骨折均获得骨性愈合,下地负重时间6～14周,平均11周.拆外固定支架时间8～14周,平均12周.按刘利民等关于骨盆骨折术后功能评定标准:优33例,良12例,中4例,差2例,优良率为88.2%.2例合并髋臼骨折者术后2年因髋关节骨关节炎行全髋关节置换术;1例因骶髂关节骨关节炎行骶髂关节融合后症状消失;1例伴骶骨骨折患者术后2年出现骶神经损伤症状,CT检查示骶管内骨赘形成,行骶管探查骶赘切除后症状缓解.结论对于Tile B1、B2型骨折单用外固定支架,C型骨折使用外固定支架结合内固定或牵引治疗,均可达到骨折复位、骨盆环稳定的作用;对多发伤患者,急诊行外固定治疗,可迅速稳定骨盆、减少出血,提高抢救成功率.
목적 탐토외고정지가재골분골절치료중적작용화우점. 방법 2002년4월지2008년7월근거Tile분형,분별채용외고정지가고정、견인+외고정지가고정、내고정+외지가동정삼충방법대55례골분골절진행복위고정,이체도골절복위、골분배은정적목적 . 결과 2례합병유흉복부다발상환자술후사망,2례실방,51례획득평균11개월수방.골절균획득골성유합,하지부중시간6～14주,평균11주.탁외고정지가시간8～14주,평균12주.안류이민등관우골분골절술후공능평정표준:우33례,량12례,중4례,차2례,우량솔위88.2%.2례합병관구골절자술후2년인관관절골관절염행전관관절치환술;1례인저가관절골관절염행저가관절융합후증상소실;1례반저골골절환자술후2년출현저신경손상증상,CT검사시저관내골췌형성,행저관탐사저췌절제후증상완해.결론 대우Tile B1、B2형골절단용외고정지가,C형골절사용외고정지가결합내고정혹견인치료,균가체도골절복위、골분배은정적작용;대다발상환자,급진행외고정치료,가신속은정골분、감소출혈,제고창구성공솔.
Objective To investigate the advantages of the external fixators used in the treatment of pelvic fracture. Methods From April 2002 to July 2008, 55 patients with unstable pelvic fracture were treated respectively with simple external fixators, external fixators plus traction and external fixators plus in-ternul fixation according to their different Tile classifications. Results Of this group, 51 cases were followed up for an average of 11 months, 2 cases died because of multi-injuries, and 2 cases were lost in the follow-up. All of the 51 patients obtained bony union. On average, it took 11 (6 to 14) weeks to achieve weight-bearing walking, and 12 (8 to 14) weeks to remove the external fixators for the patients. By Liu Li-ming's evaluation system, the good to excellent rate was up to 88.2%. Conclusions The pelvic fractures of Tile B1 and B2 can be treated with simple external fixators and those of Tile C with external fix-ators plus internal fixation or traction to achieve fracture reduction and stability of the pelvic ring. For the patients with multi-injuries, external fixators used in the emergency treatment can stabilize the pelvic ring, reduce blood loss and improve the success rate.