CAJ | 학술논문

目的：评价三维导航辅助经皮骶髂螺钉置入治疗骨盆后环骨折的安全性和有效性。方法我院骨科2009年3月～2012年12月采取三维导航辅助技术经皮置入骶髂螺钉治疗骨盆后环骨折患者18例，男性13例，女性5例；年龄23～61岁，平均40.2岁。道路交通伤12例，坠落伤5例，房屋倒塌砸伤1例。伤后就诊时间3h～5d（平均25h）。按照AO骨折分型： B1.2型3例，B2.2型2例，C1.2型7例，C1.3型5例，C2.3型1例。结果共置入骶髂螺钉40枚，每枚螺钉置入耗时20～38min，平均（29.12±3.00） min，术中透视时间3.5～5.2min，平均（4.55±0.80）min，每枚螺钉置入出血量10～20ml。所有螺钉置入位置均较满意，无伤口感染发生，术后均未出现明显神经系统并发症。采用Matta评分标准评价骨折复位情况：优12例，良5例，可1例，总体优良率94％。采用Majeed骨盆骨折量化评估体系进行功能评价：优11例，良7例，总体优良率100％。结论三维导航技术辅助经皮骶髂螺钉置入治疗骨盆后环骨折具有良好的可操作性和更高的安全性。
목적：평개삼유도항보조경피저가라정치입치료골분후배골절적안전성화유효성。방법아원골과2009년3월～2012년12월채취삼유도항보조기술경피치입저가라정치료골분후배골절환자18례，남성13례，녀성5례；년령23～61세，평균40.2세。도로교통상12례，추락상5례，방옥도탑잡상1례。상후취진시간3h～5d（평균25h）。안조AO골절분형： B1.2형3례，B2.2형2례，C1.2형7례，C1.3형5례，C2.3형1례。결과공치입저가라정40매，매매라정치입모시20～38min，평균（29.12±3.00） min，술중투시시간3.5～5.2min，평균（4.55±0.80）min，매매라정치입출혈량10～20ml。소유라정치입위치균교만의，무상구감염발생，술후균미출현명현신경계통병발증。채용Matta평분표준평개골절복위정황：우12례，량5례，가1례，총체우량솔94％。채용Majeed골분골절양화평고체계진행공능평개：우11례，량7례，총체우량솔100％。결론삼유도항기술보조경피저가라정치입치료골분후배골절구유량호적가조작성화경고적안전성。
Objective To evaluate the application of 3D fluoroscopy navigation-assisted percutaneous screw fixation in the treatment of unstable posterior pelvic ring trauma .Methods Between Mar.2009 to Dec.2012,18 patients with posterior pelvic ring injuries were included for percutaneous screw fixation using an optoelectronic 3D-fluoroscopy navigation system .There were 13 males and 5 females with an average age of 40.2 years ( ranged from 23 to 61 years).Fractures were caused by traffic accident in 12 cases,high fall injury in 5 cases,and collapsed building in 1 case.The interval from injury to hospitalization was 3h-5d (mean 25h).According to the AO classi-fication, there were 3 cases of B1.2 type,2 cases of B2.2 type,7 cases of C1.2 type,5 cases of C1.3 type,and 1 case of C2.3 type.Results Totally 40 iliosacral screws were inserted ( mean operation time per screw 29.12 ± 3.00 minutes,mean fluoroscopy time per screw 4.55 ±0.80 minutes).The blood loss ranged from 10 to 20 ml. The postoperative pelvic X ray and three dimensional CT showed that the fractures had good reduction and all the screws had good position .No screw misplacement was observed in intraoperative fluoroscopic images .There were no wound infections , neurovascualr injuries or other organ injuries .According to the rating system of Matta ,12 pa-tients had excellent results ,5 patients had good results ,and 1 patient had a fair result .The excellent to good rate was 94%.According to Majeed functional scoring the results were excellent in 11 cases and good in 7 cases,with an excellent and good rate of 100%.Conclusion Percutaneous screw fixation with 3D fluoroscopy-assisted navigation of pelvic ring fractures can produce excellent results in selected patients .It is a safe and effective alternative for the treatment of pelvic ring fractures .