联合切口治疗罕见的骶髂关节前脱位

The united incisions in treatment of anterior dislocations of sacroiliac joint

目的总结联合切口治疗骶髂关节前脱位的经验。方法通过前后联合切口将骶髂关节前脱位进行复位固定。患者健侧卧位(术中可行侧俯或侧仰变动体位),全麻。后侧取骶髂关节弧形切口,前侧Pfannenstiel切口。后侧切口显露骶髂关节耳状面,因髂腰肌牵拉无法复位,于耻骨上缘横行切开,沿耻骨梳将髂骨内侧肌肉推开,骨膜剥离器自后切口内撬拨髂骨内缘复位,重建板内固定,加强关节稳定。结果X线片显示复位固定满意。结论骶髂前脱位单一切口复位困难,前后联合切口,复位固定可达满意疗效。

Objective To summarize the experience of treating anterior dislocations of sacroiliac joints. Methods The anterior and posterior united incisions was used in reduction fixation of anterior dislocations of sacroiliac joints. The patient was operated in recumbent in uninjured side with general anesthesia. An arc incision was taken in posterior sacroiliac joint, and Pfannenstiel incision in the anterior. The posterior incision revealed the facies auricularis, but sacroiliac joint couldn＇t be reduced because of iliopsoas. And the Pfannenstiel incision was made for internal fixation. Results X-ray film showed that the reduction fixation was satisfied. Conclusion For anterior dislocations of sacroiliac joint, single incision is difficult for the reduction of anterior dislocations of sacroiliac joint, but the united incisions can be satisfied.