CAJ | 학술논문

目的探讨有限切开入路治疗骨盆骨折的手术方式及其疗效.方法选择2008年1月-2011年11月44例骨盆骨折患者采取有限切开进行治疗,其中男31例,女13例;年龄21～70岁,平均38.3岁.骨折按Tile分型:Tile B型25例(B1 11例,B2 14例),Tile C型19例(C1～2 14例,C1～34例,C21例).均采用手术治疗,其中单独采用Stoppa入路切开10例,Stoppa入路联合部分髂腹股沟入路切开13例;Stoppa入路联合后方微创入路切开13例;单独采用间断切开髂腹股沟入路切开5例;间断切开髂腹股沟入路联合后方微创入路切开3例.结果骨盆骨折前后环损伤患者术中复位均优(骨折部位分离＜4 mm).随访6～35个月,平均17个月所有患者均达到完全负重行走,X线片均提示骨性愈合.未出现骨折移位及内固定松动.有限切开入路的切口长度、平均手术时间、术中平均出血量均优于常规髂腹股沟入路.结论采用有限切开入路治疗骨盆骨折,具有手术操作简便、手术切口小、手术时间短、出血量少、并发症少的优点,是值得临床推广的手术方式.
목적 탐토유한절개입로치료골분골절적수술방식급기료효.방법 선택2008년1월-2011년11월44례골분골절환자채취유한절개진행치료,기중남31례,녀13례;년령21～70세,평균38.3세.골절안Tile분형:Tile B형25례(B1 11례,B2 14례),Tile C형19례(C1～2 14례,C1～34례,C21례).균채용수술치료,기중단독채용Stoppa입로절개10례,Stoppa입로연합부분가복고구입로절개13례;Stoppa입로연합후방미창입로절개13례;단독채용간단절개가복고구입로절개5례;간단절개가복고구입로연합후방미창입로절개3례.결과 골분골절전후배손상환자술중복위균우(골절부위분리＜4 mm).수방6～35개월,평균17개월소유환자균체도완전부중행주,X선편균제시골성유합.미출현골절이위급내고정송동.유한절개입로적절구장도、평균수술시간、술중평균출혈량균우우상규가복고구입로.결론 채용유한절개입로치료골분골절,구유수술조작간편、수술절구소、수술시간단、출혈량소、병발증소적우점,시치득림상추엄적수술방식.
Objective To investigate methods and curative outcomes of limited incision approach in treatment of pelvic fractures.Methods The study involved 44 patients suffering from pelvic fractures treated by limited incision from January 2008 to December 2011,including 31 males and 13 females,at age range of 21-70 years (average 38.3 years).According to Tile classification,25 cases were with type B fractures (11 of type B1 and 14 of type B2),and 19 with type C fractures (14 with type C1-2,four with C1-3,one with type C2).Surgical incision methods included simple Stoppa approach in 10 cases,Stoppa plus partial ilioinguinal approaches in 13,Stoppa approach plus posterior minimally invasive approaches in 13,discontinuous ilioinguinal approach in five,and discontinuous ilioinguinal plus posterior minimally invasive approaches in three.Results The patients with anterior and posterior pelvic ring injury achieved excellent reduction (separation of fracture sites ＜4 mm).All patients could walk in full weight bearing during 6-35 months of follow-up (average 17 months).In the meantime,X-ray radiographs indicated bony union in all cases.There was no fracture displacement or implant loosening.Limited incision approach gained advantages of short incision length,short operation time and little intraoperative blood loss in comparison with traditional ilioinguinal approach.Conclusion Limited incision approach has merits of easy operation,small wounds,short operation time,minimal hemorrhage and few complications in treatment of pelvic fractures and thus is a surgery method worthy of clinical use.