摘要
目的探讨髂腰椎椎弓根螺钉联合骨盆前环钢板内固定治疗DenisⅡ型骶骨骨折并骨盆前环骨折的临床疗效。方法回顾性分析2015年1月-2016年1月西安交通大学医学院附属红会医院收治的14例采用髂腰椎椎弓根螺钉联合骨盆前环钢板内固定治疗的DenisⅡ型骶骨骨折并骨盆前环骨折患者的临床资料。统计分析所有患者手术时间、术中出血量及并发症发生情况,骶神经功能Gibbons评分,骨盆损伤恢复情况Majeed评分,末次随访时骨盆X线片及CT资料上的骨折复位、内固定及愈合情况。结果所有手术顺利完成,随访12~24个月,平均16个月。手术时间3.5~4.6 h,平均4.0 h;术中出血量550~960 mL,平均770 mL。术后Gibbons评分为(2.00±1.07)分,较术前的(3.00±0.75)分明显改善,差异有统计学意义(P<0.05);Majeed评分系统量化评估盆骨损伤恢复情况,优9例,良4例,可1例。所有患者末次随访时骨盆X线片及CT示内固定在位,无断裂、松动,骶骨骨折及骨盆前环骨折完全骨性愈合。结论应用髂腰椎椎弓根螺钉联合骨盆前环钢板内固定治疗DenisⅡ型骶骨骨折并骨盆前环骨折疗效满意。
Objective To explore the clinical efficacy of iliolumbar pedicle screw and anterior pelvic ring plate internal fixation for DenisⅡ sacral fracture and anterior pelvic ring fracture. Methods The clinical data of 14 patients with DenisⅡ sacral fracture and anterior pelvic ring fracture admitted to Honghui Hospital affiliated Xi’an Jiaotong University Medical College from January 2015 to January 2016 were retrospectively analyzed. All the patients received iliolumbar pedicle screw and anterior pelvic ring plate internal fixation. The operation time,intraoperative blood loss and complications,Gibbons score for sacral nerve function,Majeed score for pelvic injury recovery,fracture reduction,internal fixation and bone fusion on roentgenographs and CTs at the final follow-up were analyzed. Results All the patients completed the operation successfully,and were followed-up for 12-24(mean 16) months. The operation time was 3.5-4.6(mean 4.0)h. The intraoperative blood loss was 550-960(mean 770)mL. Gibbons scores before and after surgery were 3.00±0.75 and 2.00±1.07 respectively,and the difference was statistically significant(P < 0.05). Recovery of pelvic injury was quantitatively evaluated by Majeed scoring system,which was excellent in 9 cases,good in 4 and fair in 1. At the final follow-up,roentgenographs and CTs of the pelvis showed that the internal fixations were left in place. No fracture or loosening occurred. Sacral fracture and anterior pelvic ring fracture healed completely. Conclusion The therapeutic efficacy of iliolumbar pedicle screw combined with anterior pelvic ring plate internal fixation for Denis Ⅱ sacral fracture and anterior pelvic ring fracture is satisfactory.
作者
张静涛
刘国良
李兵
李小建
闫丽萍
杨小彬
周劲松
ZHANG Jing-tao;LIU Guo-liang;LI Bing;LI Xiao-jian;YAN Li-ping;YANG Xiao-bin;ZHOU Jin-song(Department of Orthopaedics,Xi’an No. 3 Hospital,Xi’an 710018,Shaanxi,China;Department of Spinal Surgery,Honghui Hospital,Xi’an Jiaotong University Medical College,Xi’an 710054,Shaanxi,China)
出处
《脊柱外科杂志》
2019年第4期240-243,共4页
Journal of Spinal Surgery
关键词
骶骨
骨盆
脊柱骨折
内固定器
Sacrum
Pelvis
Spinal fractures
Internal fixators
