逆向经皮空心螺钉固定耻骨上支治疗耻骨支内、外侧骨折的效果

Reverse Percutaneous Cannulated Screw Fixation of the Suprapubic Branch for the Treatment of Internal and External Fractures of the Pubic Symphysis

目的研究逆向经皮空心螺钉固定耻骨上支治疗耻骨支内、外侧骨折的效果。方法选择该院耻骨上支不稳定性骨折患者30例,病例选取时间在2017年3月—2019年5月,对患者的手术情况以及随访情况进行评估调查,对比患者在耻骨支内、外侧骨折的情况。结果比较耻骨上支内、外侧骨折固定手术时间及术中失血量,发现内侧骨折固定手术时间较短(55.2±14.3)min,失血量较多(42.8±4.8)mL,外侧骨折手术时间较长(76.4±15.3)min,失血量较少(41.6±5.6)mL(t=3.867,P<0.05;t=0.618,P<0.05,P>0.05)。患者在伤口感染、周围器官损伤、肌肉萎缩、褥疮、神经损伤等并发症方面均无发生。所有患者中有1例患者出现内固定周围骨折,还有1例患者出现退钉现象。结论逆向经皮空心螺钉固定耻骨上支治疗耻骨支内、外侧骨折的临床效果显著,而且内侧手术治疗所花费的时间较短,在临床效果方面,内侧外侧骨折效果无明显差异。

Objective To study the effect of retrograde percutaneous cannulated screws on the treatment of pubic symphysis fractures.Methods Thirty patients with unstable fractures of the suprapubic symphysis in the hospital were selected.The cases were selected from March 2017 to May 2019.The patient’s operation and follow-up were evaluated.The patients were compared inside and outside the pubic symphysis condition of the fracture.Results Compared with the intraoperative and intraoperative blood loss of the upper and lower pubic symphysis,it was found that the medial fracture fixation time was shorter(55.2±14.3)min,the blood loss was more(42.8±4.8)mL,and the lateral fracture surgery time was longer(76.4±15.3)min,less blood loss(41.6±5.6)mL(t=3.867,P<0.05;t=0.618,P>0.05).The patient did not develop complications such as wound infection,peripheral organ damage,muscle atrophy,hemorrhoids,and nerve damage.One patient had an internal fixation fracture,and one patient had a nail removal.Conclusion The clinical effect of ret-rograde percutaneous cannulated screw fixation on the internal and lateral pubic fractures is significant,and the time spent on medial surgery is shorter.In terms of clinical effect,there is no significant difference in the medial lateral fracture.