北京大学学报（医学版）
北京大學學報（醫學版）
북경대학학보（의학판）
JOURNAL OF BEIJING MEDICAL UNIVERSITY(HEALTH SCIENCES)
2015年
2期
276-280
,共5页
吴宏华%吴新宝%李宇能%杨明辉%王满宜
吳宏華%吳新寶%李宇能%楊明輝%王滿宜
오굉화%오신보%리우능%양명휘%왕만의
骨盆骨%骨折%骶髂关节%脱位%外科手术
骨盆骨%骨摺%骶髂關節%脫位%外科手術
골분골%골절%저가관절%탈위%외과수술
Pelvic bones%Fracture,bone%Sacroiliac joint%Dislocations%Surgical procedures,operative
目的：总结伴有骶髂关节完全性前脱位的骨盆骨折的治疗经验。方法：对北京积水潭医院2008年2月至2014年3月收治的6例伴有骶髂关节完全性前脱位骨盆骨折的资料进行回顾性分析，描述患者病史、损伤程度、急诊救治等特征，通过影像学判断损伤情况，给予手术治疗，术后功能锻炼，并对患者进行随访以评估术后恢复情况，总结治疗经验。结果：全部6例患者术后愈合良好，无感染和术后神经症状出现，X线示骶髂关节复位良好。随访1．6年（8个月至2年），患者6个月后Majeed功能评分优2例、良2例、可1例、差1例，评分差的病例主要表现为持续疼痛，肢体活动能力下降，行走长距离时需用手杖，有跛行。评分低的2例患者不能恢复原有工作。结论：伴有骶髂关节完全性前脱位的骨盆骨折是一种特殊类型的损伤，急诊处理困难，应尽早手术，前方入路有利于脱位的复位和固定。
目的：總結伴有骶髂關節完全性前脫位的骨盆骨摺的治療經驗。方法：對北京積水潭醫院2008年2月至2014年3月收治的6例伴有骶髂關節完全性前脫位骨盆骨摺的資料進行迴顧性分析，描述患者病史、損傷程度、急診救治等特徵，通過影像學判斷損傷情況，給予手術治療，術後功能鍛煉，併對患者進行隨訪以評估術後恢複情況，總結治療經驗。結果：全部6例患者術後愈閤良好，無感染和術後神經癥狀齣現，X線示骶髂關節複位良好。隨訪1．6年（8箇月至2年），患者6箇月後Majeed功能評分優2例、良2例、可1例、差1例，評分差的病例主要錶現為持續疼痛，肢體活動能力下降，行走長距離時需用手杖，有跛行。評分低的2例患者不能恢複原有工作。結論：伴有骶髂關節完全性前脫位的骨盆骨摺是一種特殊類型的損傷，急診處理睏難，應儘早手術，前方入路有利于脫位的複位和固定。
목적：총결반유저가관절완전성전탈위적골분골절적치료경험。방법：대북경적수담의원2008년2월지2014년3월수치적6례반유저가관절완전성전탈위골분골절적자료진행회고성분석，묘술환자병사、손상정도、급진구치등특정，통과영상학판단손상정황，급여수술치료，술후공능단련，병대환자진행수방이평고술후회복정황，총결치료경험。결과：전부6례환자술후유합량호，무감염화술후신경증상출현，X선시저가관절복위량호。수방1．6년（8개월지2년），환자6개월후Majeed공능평분우2례、량2례、가1례、차1례，평분차적병례주요표현위지속동통，지체활동능력하강，행주장거리시수용수장，유파행。평분저적2례환자불능회복원유공작。결론：반유저가관절완전성전탈위적골분골절시일충특수류형적손상，급진처리곤난，응진조수술，전방입로유리우탈위적복위화고정。
Objective:To investigate the management of pelvic injury associated with complete anterior sacroiliac joint dislocation.Methods:In the study, 6 cases of pelvic injury associated with complete an-terior sacroiliac joint dislocation treated in Beijing Jishuitan Hospital from February 2008 to June 2014 were analyzed.We described the history and severity of injury, emergency treatment, and fracture radio-logy.In all the cases, the surgical treatment and postoperative functional exercise were performed.We followed up all the cases on an average of 1.6 years, assessed the postoperative recovery and summed up the treatment experience.Results:All the 6 patients with fractures recovered without infection and nerve symptoms after surgery.Their X-rays showed good reduction of sacroiliac joints.All the cases were followed up on an average of 1.6 years.Six months after surgery, the Majeed scores were perfect in 2 cases, good in 2, fair in 1, and poor in 1.The patients with poor scores suffered persistent pain, and decreased physical activity, and when walking long distances, they needed a walking stick.The 2 patients with low scores could not resume the original work.Conclusion:Pelvic injury associated with complete anterior sacroiliac joint dislocation is a special type of the pelvic injury since the managements during the emergency phase are difficult.The surgery should be done as early as possible, and the anterior approach is available for the reduction and fixation.
