CAJ | 학술논문

目的评价骶髂螺钉联合外固定架或前柱螺钉治疗骨盆后环损伤伴前环耻骨支、坐骨支骨折的临床疗效与并发症. 方法回顾2007年12月-2012年12月骨盆后环损伤伴前环耻骨支、坐骨支骨折患者91例,其中男67例,女24例;年龄22～61岁,平均37.8岁.51例采用骶髂螺钉联合外固定架治疗(外固定架组),40例采用骶髂螺钉联合前柱螺钉治疗(前柱螺钉组).从术后并发症、术后下地时间、骨折愈合情况、Majeed骨盆功能评分和视觉模拟评分(visual aualogue scale,VAS)等方面进行对比分析. 结果 88例获得随访,时间12～26个月,平均13.6个月.两种手术方式在术后并发症和骨折愈合方面差异无统计学意义.前柱螺钉组术后下地时间(31.0±6.2)d、Majeed骨盆功能评分(优良率为95％)和VAS(1.1±1.3)分均明显优于外固定架组[(41.9±7.2)d、优良率为73％、(3.5±2.0)分](P＜0.05). 结论骶髂螺钉联合前柱螺钉治疗骨盆后环损伤伴前环耻骨支、坐骨支骨折具有术后下地时间早、疼痛减轻、并发症少等优点,是治疗骨盆前后环骨折的一种可选择的手术方法.
목적 평개저가라정연합외고정가혹전주라정치료골분후배손상반전배치골지、좌골지골절적림상료효여병발증. 방법 회고2007년12월-2012년12월골분후배손상반전배치골지、좌골지골절환자91례,기중남67례,녀24례;년령22～61세,평균37.8세.51례채용저가라정연합외고정가치료(외고정가조),40례채용저가라정연합전주라정치료(전주라정조).종술후병발증、술후하지시간、골절유합정황、Majeed골분공능평분화시각모의평분(visual aualogue scale,VAS)등방면진행대비분석. 결과 88례획득수방,시간12～26개월,평균13.6개월.량충수술방식재술후병발증화골절유합방면차이무통계학의의.전주라정조술후하지시간(31.0±6.2)d、Majeed골분공능평분(우량솔위95％)화VAS(1.1±1.3)분균명현우우외고정가조[(41.9±7.2)d、우량솔위73％、(3.5±2.0)분](P＜0.05). 결론 저가라정연합전주라정치료골분후배손상반전배치골지、좌골지골절구유술후하지시간조、동통감경、병발증소등우점,시치료골분전후배골절적일충가선택적수술방법.
Objective To evaluate the clinical effects and complications of sacroiliac screw instrumentation combined either with external fixation or anterior column screw fixation for treatment of posterior pelvic ring injury combined with fractures of anterior pubic and ischiadic ramus.Methods A retrospective review was conducted on 91 patients with posterior pelvic ring injury combined with fractures of anterior pubic and ischiadic ramus treated between December 2007 and December 2012.There were 67 males and 24 females aged at 22-61 years (mean,37.8 years).All together,51 out of the patients were treated with sacroiliac screws combined with external fixation and 40 underwent sacroiliac screw fixation combined with anterior screw fixation.Comparative analysis of the two surgical treatments were made in aspect of postoperative complications,postoperative ambulation time,fracture healing,Majeed pelvic function score,and visual analogue scale (VAS).Results Eighty-eight patients were available for the mean 13.6 months of follow-up (range,12-26 months).Except for postoperative complications and fracture healing,postoperative ambulation time [(31.0 ± 6.2) d vs (41.9 ± 7.2) d],excellence rate in Majeed pelvic function score (95％ vs 73％) and VAS score[(1.1 ± 1.3) points vs (3.5 ±2.0) points]were significantly better in patients treated with anterior column screw than in patients undergoing external fixation (P ＜ 0.05).Conclusion Sacroiliac screw combined with anterior column screw as an alternative to treat posterior pelvic ring injury combined with fractures of anterior pubic and ischiadic ramus advantages in early ambulation,relief of the pain,and few complications.