中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2015年
4期
305-308
,共4页
雷文雄%方锦涛%苏万汉%冯小仍%陈滨
雷文雄%方錦濤%囌萬漢%馮小仍%陳濱
뢰문웅%방금도%소만한%풍소잉%진빈
骨盆%骨折%骨折固定术,内%骨板%手术入路
骨盆%骨摺%骨摺固定術,內%骨闆%手術入路
골분%골절%골절고정술,내%골판%수술입로
Pelvis%Fractures,bone%Fracture fixation,internal%Bone plates%Surgical approach
目的 探讨改良Stoppa入路治疗骨盆前环骨折的疗效. 方法 回顾性分析2009年3月至2013年6月收治的40例(55侧)骨盆前环骨折患者资料,男24例(31侧),女16例(24侧);平均年龄为34.4岁(21 ～ 65岁).骨折Tile分型:A型2例,B型21例,C型17例.受伤至手术时间平均为6.5 d(3 ～12 d).所有患者均采用改良Stoppa入路手术,其中23例患者采用单纯骨盆前环钢板固定,17例患者采用骨盆前环钢板加后环固定.记录患者的切口长度、手术时间、术中出血量、骨折复位质量及疗效等. 结果 本组40例患者的手术切口长度平均为8.2 cm,手术时间平均为78.4 min,术中出血量平均为420 mL.术后根据Matta标准评定骨折复位质量:所有骨盆前环骨折均获满意复位.手术并发症:1例患者术中发生髂外血管损伤,1例患者取钢板后伤口迁延不愈.36例患者术后获8 ～ 24个月(平均18个月)随访,4例患者失访.骨折愈合时间为3.0～5.5个月,平均3.8个月.末次随访时采用Majeed功能评分系统评定疗效:评分平均为84.4分;优21例,良13例,可2例,优良率达95.0％.随访期间无一例患者发生骨折不愈合、延迟愈合或畸形愈合及异位骨化等并发症. 结论在骨盆前环骨折的治疗中,改良Stoppa入路具有手术切口小、术野清晰、复位效果好、并发症少且术后功能恢复快等优点.
目的 探討改良Stoppa入路治療骨盆前環骨摺的療效. 方法 迴顧性分析2009年3月至2013年6月收治的40例(55側)骨盆前環骨摺患者資料,男24例(31側),女16例(24側);平均年齡為34.4歲(21 ～ 65歲).骨摺Tile分型:A型2例,B型21例,C型17例.受傷至手術時間平均為6.5 d(3 ～12 d).所有患者均採用改良Stoppa入路手術,其中23例患者採用單純骨盆前環鋼闆固定,17例患者採用骨盆前環鋼闆加後環固定.記錄患者的切口長度、手術時間、術中齣血量、骨摺複位質量及療效等. 結果 本組40例患者的手術切口長度平均為8.2 cm,手術時間平均為78.4 min,術中齣血量平均為420 mL.術後根據Matta標準評定骨摺複位質量:所有骨盆前環骨摺均穫滿意複位.手術併髮癥:1例患者術中髮生髂外血管損傷,1例患者取鋼闆後傷口遷延不愈.36例患者術後穫8 ～ 24箇月(平均18箇月)隨訪,4例患者失訪.骨摺愈閤時間為3.0～5.5箇月,平均3.8箇月.末次隨訪時採用Majeed功能評分繫統評定療效:評分平均為84.4分;優21例,良13例,可2例,優良率達95.0％.隨訪期間無一例患者髮生骨摺不愈閤、延遲愈閤或畸形愈閤及異位骨化等併髮癥. 結論在骨盆前環骨摺的治療中,改良Stoppa入路具有手術切口小、術野清晰、複位效果好、併髮癥少且術後功能恢複快等優點.
목적 탐토개량Stoppa입로치료골분전배골절적료효. 방법 회고성분석2009년3월지2013년6월수치적40례(55측)골분전배골절환자자료,남24례(31측),녀16례(24측);평균년령위34.4세(21 ～ 65세).골절Tile분형:A형2례,B형21례,C형17례.수상지수술시간평균위6.5 d(3 ～12 d).소유환자균채용개량Stoppa입로수술,기중23례환자채용단순골분전배강판고정,17례환자채용골분전배강판가후배고정.기록환자적절구장도、수술시간、술중출혈량、골절복위질량급료효등. 결과 본조40례환자적수술절구장도평균위8.2 cm,수술시간평균위78.4 min,술중출혈량평균위420 mL.술후근거Matta표준평정골절복위질량:소유골분전배골절균획만의복위.수술병발증:1례환자술중발생가외혈관손상,1례환자취강판후상구천연불유.36례환자술후획8 ～ 24개월(평균18개월)수방,4례환자실방.골절유합시간위3.0～5.5개월,평균3.8개월.말차수방시채용Majeed공능평분계통평정료효:평분평균위84.4분;우21례,량13례,가2례,우량솔체95.0％.수방기간무일례환자발생골절불유합、연지유합혹기형유합급이위골화등병발증. 결론재골분전배골절적치료중,개량Stoppa입로구유수술절구소、술야청석、복위효과호、병발증소차술후공능회복쾌등우점.
Objective To evaluate the modified Stoppa approach for treatment of fracture of anterior pelvic ring.Methods From March 2009 to June 2013,40 patients with fracture of anterior pelvic ring (55 sides) were treated through the modified Stoppa approach at our department.They were 24 males (31 sides) and 16 females (24 sides),aged from 21 to 65 years (average,34.4 years).According to the Tile classification,2 cases were type A,21 cases type B and 17 cases type C.The mean time from injury to surgery was 6.5 days (from 3 to 12 days).Simple plate fixation of the anterior pelvic ring was performed in 23 cases while 17 cases underwent plate fixation of the anterior pelvic ring plus additional fixation of the posterior pelvic ring.The incision length,operation time,blood loss,reduction quality and clinical rehabilitation were documented.Results On average,incision length was 8.2 cm,operation time 78.4 min and blood loss 420 mL for this cohort.According to Matta standard,all the 55 fractures obtained excellent reduction.Intraoperative vascular injury occurred in one case and delayed wound healing after plate removal in another.Of this group,36 were followed up from 8 to 24 months (average,18 months) and 4 lost.The fractures healed after 3 to 5.5 months (average,3.8 months).The functional evaluation by the Majeed system scored an average of 84.4 points.Twenty-one cases were rated as excellent,13 as good and 2 as fair,resulting in an excellent and good rate of 95.0％.No nonunion,delayed union,malunion or heterotopic ossification was found in the follow-ups.Conclusion In treatment of fracture of anterior pelvic ring,the modified Stoppa approach has advantages of small incision,fine visualization,quality reduction,a low rate of complications and rapid rehabilitation.
