摘要
目的报道运用微创骨膜下隧道锁定接骨板内固定治疗35例骨盆前环骨折的临床效果。方法2007年1月至2012年6月，共收治骨盆前环骨折35例，男27例，女8例；年龄25～65岁，平均年龄f44．1±13．9）岁；耻骨支骨折26例，髋臼前柱骨折9例。5例合并后环骨折，11例合并四肢骨折，3例合并胸腹部脏器损伤，3例合并尿道损伤，3例合并颅脑损伤，2例合并颈髓损伤。按损伤骨科理论给予稳定骨盆、抗休克处理、患肢骨牵引等处理，生命体征平稳后全部行微创骨膜下隧道锁定接骨板内固定治疗。结果35例均获随访，随访时间6—24个月，平均（13．6±7．4）个月，手术时间30—60min（不包括后环及其它部位骨折固定时间），平均（45．4±6．4）rain，出血量50—90ml（不包括其它骨折固定），平均（65．4±10．6）ml。采用Matta标准对术后x线评估：解剖复位18例，复位良好14例，复位较差3例，采用Lindahl标准对骨盆功能评分：优28例，良7例，平均得分（76．8±1．4）分。结论采用微创骨膜下隧道锁定接骨板内固定治疗骨盆前环骨折创伤小、手术时间短、安全性高、出血少。
Objective To report the clinical effects of internal fixation by the locking compression plate through the minimal incision and subperiosteal tunnel in the treatment of 35 cases of anterior pelvic ring fractures. Methods 35 patients with anterior pelvic ring fractures were admitted from January 2007 to June 2012. There were 27 males and 8 female, whose average age was （ 44.1±13.9 ） years old （ range; 25-65 years ）. 26 patients were diagnosed as fractures of the pubic rami, and 9 patients were diagnosed as fractures of the acetabular anterior column. 5 patients were combined with posterior ring fractures, 11 patients combined with limbs fractures, 3 patients combined with thoracic and abdominal organ injuries, 3 patients combined with urethral injuries, 3 patients combined with craniocerebral injuries and 2 patients combined with cervical spinal cord injuries. According to the damage control orthopedics, all patients were treated with pelvic stabilization, anti-shock, limb traction and so on, and then internal fixation by the locking compression plate through the minimal incision and subperiosteal tunnel when the vital signs were stable. Results All patients were followed up for an average of （ 13.6±7.4 ） months （ range; 6-24 months ）. The mean operation time was （ 45.4±6.4 ） min （ range; 30-60 min ）, and the fracture fixation time of the posterior pelvic ring and other parts were not included. The mean blood loss was （ 65.4±10.6 ） ml （ range, 50-90 ml ）, and the blood loss in other fracture fixations was not included. According to the Matta standard, the postoperative X-ray showed 18 cases of anatomical reduction, 14 cases of good reduction and 3 cases of poor reduction. According to the Lindahl standard, the pelvic function was excellent in 28 cases and good in 7 cases, with an average score of （ 76.8~1.4 ） points. Conclusions Internal fixation by the locking compression plate through the minimal incision and subperiosteal tunnel is a safe method in the treatment of anterior pelvic ring fractures, with the advantages of minor trauma, short operation time and less bleeding.
出处
《中国骨与关节杂志》
2013年第11期637-640,共4页
Chinese Journal of Bone and Joint
关键词
耻骨
髋臼
骨盆骨
骨折固定术
内
外科手术
微创性
Pubic bone
Acetabulum
Pelvic bones
Fracture fixation, internal
Surgical procedures,minimally invasive
