地震伤骨盆骨折后环不稳的微创治疗
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摘要
目的探讨地震伤骨盆骨折后环不稳微创治疗的技术要点及疗效。方法对9例地震伤骨盆骨折后环不稳,采用前环钢板内固定后环在C型臂X线机引导下经皮微创置入骶髂空心拉力螺钉内固定。结果骨盆骨折后环不稳患者在C型臂X线机引导下经皮微创置入骶髂空心拉力螺钉内固定,疗效满意。结论掌握经皮骶髂关节置钉技术要点,采用骶髂拉力螺钉微创固定后环是地震伤骨盆骨折后环不稳的最佳治疗方法之一。
Objective To investigate the technical points and efficacy of minimally invasive surgery in treating patients with unstable posterior pelvic ring injured in the earthquake.Methods Nine patients with unstable posterior pelvic ring received anterior ring open reduction internal fixation at first,and then received pelvic posterior ring fixation with cannulated lag screw guided under C-arm X-ray.Results The cannulated lag screw was successfully implanted into sacroiliac joint percutaneously guided under C-arm X-ray.All the patients achieved satisfied reduction with less bleeding and less damage.Conclusion It is an optimum choice for treating unstable posterior pelvic ring with anterior ring open reduction internal fixation combined with cannulated lag screw percutaneously implanted under C-arm X-ray.
Objective To investigate the technical points and efficacy of minimally invasive surgery in treating patients with unstable posterior pelvic ring injured in the earthquake.Methods Nine patients with unstable posterior pelvic ring received anterior ring open reduction internal fixation at first,and then received pelvic posterior ring fixation with cannulated lag screw guided under C-arm X-ray.Results The cannulated lag screw was successfully implanted into sacroiliac joint percutaneously guided under C-arm X-ray.All the patients achieved satisfied reduction with less bleeding and less damage.Conclusion It is an optimum choice for treating unstable posterior pelvic ring with anterior ring open reduction internal fixation combined with cannulated lag screw percutaneously implanted under C-arm X-ray.
引文
[1]高勇,饶放萍,钟雪萍,等.腰骶-髂骨脊柱椎弓根钉棒内固定固定系统在C1.2型骨盆骨折中的应用.中国骨与关节损伤杂志,2010,25(8):711～712
[2]李亚洲,潘进社,彭阿钦,等.骨盆后环骨折神经损伤的临床解剖学研究.中国临床解剖学杂志,2004,22(2):122～125
[3]Tile M.Pelvic ring fractures:should they be fixed?J Bone Joint Surg(Br),1988,70(1):1～12
[4]郭前进,王亮,甄相周,等.CT引导下仰卧位骶髂置钉术治疗骨盆后环损伤.中国骨与关节损伤杂志,2010,25(1):74～75
[5]Simonian PT,Routt ML Jr.Biomechanics of pelvic fixation.OrthopClin North Am,1997,28(3):351～367
[6]Sagi HC,Ordway NR,DiPasquale T.Biomechanical analysis of fixa-tion for vertically unstable sacroiliac dislocations with iliosacralscrews and symphyseal plating.J Orthop Trauma,2004,18(3):138～143
[7]Moed BR,Ahmad BK,Craig JG,et al.Intraoperative monitoring withstimulus-evoked electromyography during placement of iliosacralscrews.An initial clinical study.J Bone Joint Surg(Am),1998,80(4):537～546
[8]Routt ML Jr,Simonian PT.Internal fixation of pelvic ring disruptions.Injury,1996,27(2):20～30
[9]高伟强,王光林,刘华渝,等.经皮骶髂螺钉固定技术治疗不稳定骨盆骨折的疗效评价.中国修复重建外科杂志,2008,22(3):321～323
[2]李亚洲,潘进社,彭阿钦,等.骨盆后环骨折神经损伤的临床解剖学研究.中国临床解剖学杂志,2004,22(2):122～125
[3]Tile M.Pelvic ring fractures:should they be fixed?J Bone Joint Surg(Br),1988,70(1):1～12
[4]郭前进,王亮,甄相周,等.CT引导下仰卧位骶髂置钉术治疗骨盆后环损伤.中国骨与关节损伤杂志,2010,25(1):74～75
[5]Simonian PT,Routt ML Jr.Biomechanics of pelvic fixation.OrthopClin North Am,1997,28(3):351～367
[6]Sagi HC,Ordway NR,DiPasquale T.Biomechanical analysis of fixa-tion for vertically unstable sacroiliac dislocations with iliosacralscrews and symphyseal plating.J Orthop Trauma,2004,18(3):138～143
[7]Moed BR,Ahmad BK,Craig JG,et al.Intraoperative monitoring withstimulus-evoked electromyography during placement of iliosacralscrews.An initial clinical study.J Bone Joint Surg(Am),1998,80(4):537～546
[8]Routt ML Jr,Simonian PT.Internal fixation of pelvic ring disruptions.Injury,1996,27(2):20～30
[9]高伟强,王光林,刘华渝,等.经皮骶髂螺钉固定技术治疗不稳定骨盆骨折的疗效评价.中国修复重建外科杂志,2008,22(3):321～323
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