中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
Chinese Journal of Orthopaedic Trauma
2015年
11期
926-930
,共5页
崔昊旻%周东生%李连欣%杨永良%卢舜%陶扶林
崔昊旻%週東生%李連訢%楊永良%盧舜%陶扶林
최호민%주동생%리련흔%양영량%로순%도부림
骨盆%骨折%骨折固定术,内%截骨术%畸形愈合
骨盆%骨摺%骨摺固定術,內%截骨術%畸形愈閤
골분%골절%골절고정술,내%절골술%기형유합
Pelvis%Fractures,bone%Fractures fixation,internal%Osteotomy%Malunion
目的 探讨髂骨截骨治疗骨盆骨折畸形愈合的临床疗效. 方法 回顾性分析2005年1月至2012年12月收治的9例骨盆骨折畸形愈合患者,男5例,女4例;平均年龄为27.0岁(22 ～35岁);初次骨盆骨折按Tile分型:C1.1型3例,C1.2型4例;C2型2例.9例患者患肢均存在不同程度短缩,平均短缩4.3 cm(3.5 ～5.2 cra).所有患者均主诉髋部疼痛、活动受限,并伴有不同程度的跛行.受伤至手术时间平均为6.2个月(3.5～11.0个月).9例患者均采用髂骨截骨、植骨双钢板内固定治疗.末次随访时采用疼痛视觉模拟评分(VAS)、骨盆骨折Majeed评分标准评定患者疗效,同时记录患者术后并发症的发生情况. 结果 9例患者术后获平均29个月(11 ～40个月)随访.末次随访时骨盆骨折Majeed评分由术前平均45.7分(42 ～ 56分)上升至85.3分(78 ～91分),疼痛VAS评分由术前平均6.1分(4～8分)降低至1.6分(0～3分).术后X线片测量示患肢延长3.3～4.0cm,平均3.6cm.1例患者术后7d发现下肢深静脉血栓形成,1例患者术后1年出现截骨侧大腿外侧囊性肿块.无一例患者发生感染、钢板断裂及脱出、医源性神经及血管损伤等并发症. 结论 髂骨截骨治疗骨盆骨折畸形愈合,能矫正骨盆畸形、延长肢体长度、重建骨盆环的稳定性,临床效果良好.
目的 探討髂骨截骨治療骨盆骨摺畸形愈閤的臨床療效. 方法 迴顧性分析2005年1月至2012年12月收治的9例骨盆骨摺畸形愈閤患者,男5例,女4例;平均年齡為27.0歲(22 ～35歲);初次骨盆骨摺按Tile分型:C1.1型3例,C1.2型4例;C2型2例.9例患者患肢均存在不同程度短縮,平均短縮4.3 cm(3.5 ～5.2 cra).所有患者均主訴髖部疼痛、活動受限,併伴有不同程度的跛行.受傷至手術時間平均為6.2箇月(3.5～11.0箇月).9例患者均採用髂骨截骨、植骨雙鋼闆內固定治療.末次隨訪時採用疼痛視覺模擬評分(VAS)、骨盆骨摺Majeed評分標準評定患者療效,同時記錄患者術後併髮癥的髮生情況. 結果 9例患者術後穫平均29箇月(11 ～40箇月)隨訪.末次隨訪時骨盆骨摺Majeed評分由術前平均45.7分(42 ～ 56分)上升至85.3分(78 ～91分),疼痛VAS評分由術前平均6.1分(4～8分)降低至1.6分(0～3分).術後X線片測量示患肢延長3.3～4.0cm,平均3.6cm.1例患者術後7d髮現下肢深靜脈血栓形成,1例患者術後1年齣現截骨側大腿外側囊性腫塊.無一例患者髮生感染、鋼闆斷裂及脫齣、醫源性神經及血管損傷等併髮癥. 結論 髂骨截骨治療骨盆骨摺畸形愈閤,能矯正骨盆畸形、延長肢體長度、重建骨盆環的穩定性,臨床效果良好.
목적 탐토가골절골치료골분골절기형유합적림상료효. 방법 회고성분석2005년1월지2012년12월수치적9례골분골절기형유합환자,남5례,녀4례;평균년령위27.0세(22 ～35세);초차골분골절안Tile분형:C1.1형3례,C1.2형4례;C2형2례.9례환자환지균존재불동정도단축,평균단축4.3 cm(3.5 ～5.2 cra).소유환자균주소관부동통、활동수한,병반유불동정도적파행.수상지수술시간평균위6.2개월(3.5～11.0개월).9례환자균채용가골절골、식골쌍강판내고정치료.말차수방시채용동통시각모의평분(VAS)、골분골절Majeed평분표준평정환자료효,동시기록환자술후병발증적발생정황. 결과 9례환자술후획평균29개월(11 ～40개월)수방.말차수방시골분골절Majeed평분유술전평균45.7분(42 ～ 56분)상승지85.3분(78 ～91분),동통VAS평분유술전평균6.1분(4～8분)강저지1.6분(0～3분).술후X선편측량시환지연장3.3～4.0cm,평균3.6cm.1례환자술후7d발현하지심정맥혈전형성,1례환자술후1년출현절골측대퇴외측낭성종괴.무일례환자발생감염、강판단렬급탈출、의원성신경급혈관손상등병발증. 결론 가골절골치료골분골절기형유합,능교정골분기형、연장지체장도、중건골분배적은정성,림상효과량호.
Objective To evaluate transiliac osteotomy for treatment of malunion of pelvic fracture.Methods From January 2005 to December 2012, 9 patients with malunion of pelvic fracture were treated in our department.They were 5 men and 4 women, 22 to 35 years of age (average, 27.0 years).According to the Tile classification, 3 cases were C1.1, 4 C1.2, and 2 C2.The mean leg length discrepancy in all patients was 4.3 cm shorter (from 3.5 to 5.2 cm).All patients complained about hip pain, limited motion and lameness more or less.The mean time from injury to surgery was 6.2 months (from 3.5 to 11.0 months).They were treated with transiliac osteotomy, bone grafting and double steel plating.Visual analogue scale (VAS) and Majeed evaluation system were used to assess functional recovery.Complications were recorded at the follow-up.Results All cases were followed up for an average duration of 29 months (from 11 to 40 months).Last follow-ups showed that the Majeed scores increased from 45.7 points (from 42 to 56 points) preoperatively to 85.3 points (from 78 to 91 points) postoperatively.The preoperative VAS scores of 6.1 points (from 4 to 8 points) decreased to 1.6 points (from 0 to 3 points) at last follow-ups.According to the pelvic X-ray films, the limbs were lengthened by an average of 3.6 cm (from 3.3 cm to 4.0 cm).Postoperative complications included deep venous thrombosis in one case and cystic mass at the affected thigh in another.No infection, fixation failure, iatrogenic nerve or vessel injury was recorded.Conclusion Transiliac osteotomy can be an effective surgical strategy to treat malunion of pelvic fracture, because it can correct pelvic deformity, lengthen the limb and rebuild stability of the pelvic ring, leading to fine functional recovery and good clinical results.
