中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2013年
5期
541-548
,共8页
王国栋%周东生%谭国庆%李连欣%李庆虎
王國棟%週東生%譚國慶%李連訢%李慶虎
왕국동%주동생%담국경%리련흔%리경호
骨盆%骶髂关节%骨折%骨折固定术,内
骨盆%骶髂關節%骨摺%骨摺固定術,內
골분%저가관절%골절%골절고정술,내
Pelvis%Sacroiliac joint%Fractures,bone%Fracture fixation,internal
目的 比较骶髂前路蝶形钢板(sacroiliac anterior papilionaceous plate,SAPP)和传统重建钢板在骶髂关节损伤治疗中的疗效.方法 回顾性分析2012年1月至2012年10月治疗23例24侧骶髂关节损伤的病历资料,11例11侧行SAPP内固定,男5例,女性6例；平均年龄为(39.6±9.1)岁；Tile B型骨折6例,C型5例.12例13侧行传统重建钢板内固定,男7例,女5例；平均年龄为(39.1±13.5)岁；Tile B型骨折7例,C型5例.两组间比较差异均无统计学意义.记录术中手术时间、出血量、骶髂关节钢板放置时间等,术后即刻行X线检查及Matta评分,术后随访时行X线检查及Majeed功能评分.结果 SAPP组平均手术时间(98.2±31.4) min,出血量(989.7±365.9) ml,钢板放置时间(6.6±3.2)min.传统重建钢板组平均手术时间(110.8±29.6) min,出血量(1136.0±279.3) ml,钢板放置时间(15.4±1.1) min.SAPP组术后Matta评分优4例、良5例、可2例,传统重建钢板组优4例、良6例、可1例、差1例.术中大出血2例,术后出现腰骶干损伤1例,股外侧皮神经损伤7例.SAPP组与传统重建钢板组相比,钢板放置时间明显缩短,Tile B型骨折出血量明显减少,余差异均无统计学意义.结论 骶髂前路蝶形钢板应用于骶髂关节损伤能够获得满意的复位和良好的固定,同传统重建钢板相比较,能易化操作、缩短放置时间、有利于旋转复位、可以减少B型骨折的出血量,并不增加神经损伤风险及感染率.
目的 比較骶髂前路蝶形鋼闆(sacroiliac anterior papilionaceous plate,SAPP)和傳統重建鋼闆在骶髂關節損傷治療中的療效.方法 迴顧性分析2012年1月至2012年10月治療23例24側骶髂關節損傷的病歷資料,11例11側行SAPP內固定,男5例,女性6例；平均年齡為(39.6±9.1)歲；Tile B型骨摺6例,C型5例.12例13側行傳統重建鋼闆內固定,男7例,女5例；平均年齡為(39.1±13.5)歲；Tile B型骨摺7例,C型5例.兩組間比較差異均無統計學意義.記錄術中手術時間、齣血量、骶髂關節鋼闆放置時間等,術後即刻行X線檢查及Matta評分,術後隨訪時行X線檢查及Majeed功能評分.結果 SAPP組平均手術時間(98.2±31.4) min,齣血量(989.7±365.9) ml,鋼闆放置時間(6.6±3.2)min.傳統重建鋼闆組平均手術時間(110.8±29.6) min,齣血量(1136.0±279.3) ml,鋼闆放置時間(15.4±1.1) min.SAPP組術後Matta評分優4例、良5例、可2例,傳統重建鋼闆組優4例、良6例、可1例、差1例.術中大齣血2例,術後齣現腰骶榦損傷1例,股外側皮神經損傷7例.SAPP組與傳統重建鋼闆組相比,鋼闆放置時間明顯縮短,Tile B型骨摺齣血量明顯減少,餘差異均無統計學意義.結論 骶髂前路蝶形鋼闆應用于骶髂關節損傷能夠穫得滿意的複位和良好的固定,同傳統重建鋼闆相比較,能易化操作、縮短放置時間、有利于鏇轉複位、可以減少B型骨摺的齣血量,併不增加神經損傷風險及感染率.
목적 비교저가전로접형강판(sacroiliac anterior papilionaceous plate,SAPP)화전통중건강판재저가관절손상치료중적료효.방법 회고성분석2012년1월지2012년10월치료23례24측저가관절손상적병력자료,11례11측행SAPP내고정,남5례,녀성6례；평균년령위(39.6±9.1)세；Tile B형골절6례,C형5례.12례13측행전통중건강판내고정,남7례,녀5례；평균년령위(39.1±13.5)세；Tile B형골절7례,C형5례.량조간비교차이균무통계학의의.기록술중수술시간、출혈량、저가관절강판방치시간등,술후즉각행X선검사급Matta평분,술후수방시행X선검사급Majeed공능평분.결과 SAPP조평균수술시간(98.2±31.4) min,출혈량(989.7±365.9) ml,강판방치시간(6.6±3.2)min.전통중건강판조평균수술시간(110.8±29.6) min,출혈량(1136.0±279.3) ml,강판방치시간(15.4±1.1) min.SAPP조술후Matta평분우4례、량5례、가2례,전통중건강판조우4례、량6례、가1례、차1례.술중대출혈2례,술후출현요저간손상1례,고외측피신경손상7례.SAPP조여전통중건강판조상비,강판방치시간명현축단,Tile B형골절출혈량명현감소,여차이균무통계학의의.결론 저가전로접형강판응용우저가관절손상능구획득만의적복위화량호적고정,동전통중건강판상비교,능역화조작、축단방치시간、유리우선전복위、가이감소B형골절적출혈량,병불증가신경손상풍험급감염솔.
Objective To compare the effect of sacroiliac anterior papilionaceous plate (SAPP) and the traditional reconstruction plate for the treatment of sacroiliac joint disruption.Methods 11 consecutive patients with sacroiliac joint disruption associated with pelvic fracture enrolled in our hospital.Detailed physical examination,X-rays,CT and FAST were performed before surgery.11 patients underwent SAPP fixation.Of the 11 patients,there were 5 males and 6 females.Their average age was 39.6 years.12 patients enrolled in last year as control group underwent reconstruction plate.There were 7 males and 5 females in this group.Their average age was 39.1 years.Operation time,blood loss,placing time of SAPP were recorded.X-ray films were performed after surgery to evaluate reduction condition by Matta criteria.X-ray films and Majeed outcome were performed in follow up.Results According to Tile classification,there were 13 Type B and 10 Type C.For SAPP group,operation time was (100.9±32.1) min,blood loss (998.8±365.7)ml,Placing time of SAPP was (6.6±3.2) min.For control group,operation time was (110.8±29.6) min,blood loss was (136.0±279.3) ml,placing time of reconstruction plate was (15.4±1.1) min.According to Matta criteria,8 cases were rated as excellent,11 as good,3 as fair,and 1 as poor.Lumbosacral nerve injury occurred in 1 case,lateral femoral cutaneous nerve injury in 7,and massive blood loss in 2 cases.No posterior infection occurred.Compared with control group,SAPP group experienced shorter placing time,and less blood loss in type B pelvic fracture.Conclusion As a new instrument,SAPP could be well applied in the treatment of sacroiliac disruption.Compared with reconstructed plate,SAPP obviously shortens placing time and facilitated placing procedure,and does not increase blood loss,neurological risk and infection rate and does not need different incision and reduction method.
