骨盆C型骨折的手术重建
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摘要
目的探讨骨盆C型骨折的临床特点及手术重建方式的选择。方法回顾性分析21例骨盆C型骨折患者的临床资料。其中,男性7例,女性14例,年龄14~68岁,平均44.4岁;根据Tile分型,C1型13例,C2型5例,C3型3例;C1型13例采用C臂透视下经皮空心拉力螺钉固定骶髂关节结合外固定架固定骨盆前环,C2、C3型8例采用切开复位重建钢板内固定术。结果术后21例复查X光片,骨盆外形接近或完全恢复;无神经血管损伤等并发症发生,为术后康复创造了良好条件。结论骨盆骨折根据分型采取不同手术方法,均能达到复位固定,重建骨盆稳定性。
Objective To discuss the clinical features of pelvic fracture of Type C and the method selection in surgical reconstruction.Methods A retrospective analysis was made to the clinical data of 21 cases with pelvic fracture of Type C,7 males and 14 females,aged from 14 to 68 with the average age of 44.4 years old;according to Tiles' classification,out of the 21 cases,13 cases had pelvic fracture of Type C1,5 cases of Type C2 and 3 cases of Type C3;the fixation of sacroiliac joint with percutaneous pubic ramus screws combined with the fixation of pelvic anterior ring by external fixation frame was selected for the 13 cases with pelvic fracture of Type C1;open reduction and plate internal fixation reconstruction was selected for the 8 cases with pelvic fracture of Type C2 and Type C3.Results The X-ray of the 21 cases after operation showed near or complete anatomical reduction of pelvis;no occurrence of complications like injuries of blood vessel or nerve.Conclusions Relevant operation methods selected for different types of pelvic fracture can lead to good effect of reduction and fixation and to reconstruct the stability of pelvis.
Objective To discuss the clinical features of pelvic fracture of Type C and the method selection in surgical reconstruction.Methods A retrospective analysis was made to the clinical data of 21 cases with pelvic fracture of Type C,7 males and 14 females,aged from 14 to 68 with the average age of 44.4 years old;according to Tiles' classification,out of the 21 cases,13 cases had pelvic fracture of Type C1,5 cases of Type C2 and 3 cases of Type C3;the fixation of sacroiliac joint with percutaneous pubic ramus screws combined with the fixation of pelvic anterior ring by external fixation frame was selected for the 13 cases with pelvic fracture of Type C1;open reduction and plate internal fixation reconstruction was selected for the 8 cases with pelvic fracture of Type C2 and Type C3.Results The X-ray of the 21 cases after operation showed near or complete anatomical reduction of pelvis;no occurrence of complications like injuries of blood vessel or nerve.Conclusions Relevant operation methods selected for different types of pelvic fracture can lead to good effect of reduction and fixation and to reconstruct the stability of pelvis.
引文
[1]Tile M.Pelvic ring fractures:should they be fixed?J Bone JointSurg.Br,1988,70(1),1~12.
[2]姜宝国,张殿英,傅中国主译.骨盆与髋臼骨折[M].北京:北京大学医学出版社,2005.45.
[3]邓少林,潘显明,屈波,等.地震伤骨盆骨折初步临床分析[J].四川医学,2008,12(6):1915~1916.
[4]邓少林,潘显明,屈波,等.复杂骨盆骨折的微创治疗[J].中国骨与关节损伤杂志,2008,12(8):887~888.
[5]Routt ML J r,Nork SE,Mills WJ,et al.Percutaneous fixation ofPelvic ring disruptions[J].Clin Orthop Relat Res,2000,37(5),15.
[6]邓少林,潘显明,马泽辉,等.经皮空心拉力螺钉结合外固定架治疗C1型骨盆骨折初步临床分析[J].西南国防医药,2008,18(6):884~885.
[7]薛波,胡勇,徐荣明,等.CT引导下空心拉力螺钉内固定治疗骶髂复合体损伤[J].骨与关节损伤杂志,2004,19(7):445~447.
[8]王亮,于四堂,刘秀民,等.仰卧位CT引导下骶髂螺钉内固定治疗骨盆后环损伤[J].中国矫形外科杂志,2007,15(20):1573~1574.
[9]Bellabarba C,Ricci WM,Bolhofner BR.Distraction externalfixa-tion.in lateral compession pevic fractures[J].J Orthop Trauma,2000,14,475.
[10]丁浩,马金忠.不稳定型骨盆骨折的手术治疗[J].中国骨与关节损伤杂志,2007,22(1):50.
[2]姜宝国,张殿英,傅中国主译.骨盆与髋臼骨折[M].北京:北京大学医学出版社,2005.45.
[3]邓少林,潘显明,屈波,等.地震伤骨盆骨折初步临床分析[J].四川医学,2008,12(6):1915~1916.
[4]邓少林,潘显明,屈波,等.复杂骨盆骨折的微创治疗[J].中国骨与关节损伤杂志,2008,12(8):887~888.
[5]Routt ML J r,Nork SE,Mills WJ,et al.Percutaneous fixation ofPelvic ring disruptions[J].Clin Orthop Relat Res,2000,37(5),15.
[6]邓少林,潘显明,马泽辉,等.经皮空心拉力螺钉结合外固定架治疗C1型骨盆骨折初步临床分析[J].西南国防医药,2008,18(6):884~885.
[7]薛波,胡勇,徐荣明,等.CT引导下空心拉力螺钉内固定治疗骶髂复合体损伤[J].骨与关节损伤杂志,2004,19(7):445~447.
[8]王亮,于四堂,刘秀民,等.仰卧位CT引导下骶髂螺钉内固定治疗骨盆后环损伤[J].中国矫形外科杂志,2007,15(20):1573~1574.
[9]Bellabarba C,Ricci WM,Bolhofner BR.Distraction externalfixa-tion.in lateral compession pevic fractures[J].J Orthop Trauma,2000,14,475.
[10]丁浩,马金忠.不稳定型骨盆骨折的手术治疗[J].中国骨与关节损伤杂志,2007,22(1):50.
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