Tile C型骨盆骨折复位质量对前后环内固定下生物力学稳定性的影响

Effect of the reduction quality of Tile C type pelvic fracture on the biomechanical stability under internal fixation of the anterior and posterior ring

目的:探讨垂直不稳定骨盆骨折在不同移位下行后环骶髂关节螺钉和前环钢板螺钉固定的稳定性差异。方法:将8具尸体骨盆随机取3具做压力测试设为正常组,然后制成垂直不稳定骨盆骨折模型,骶髂关节和耻骨联合在移位0～4mm(低度移位组)及移位8～12mm(高度移位组)行后环骶髂关节螺钉和前环钢板螺钉固定,测量骶髂关节和耻骨联合的垂直和水平移位。结果:在不同移位下的垂直不稳定骨盆骨折行前后环内固定,低度移位组骨盆稳定性显著高于高度移位组。结论:垂直不稳定骨盆骨折尽量取得解剖复位固定,确保骶髂关节移位<4mm,以提高骨盆环内固定的生物力学稳定性,有利于功能康复。

Objective： To study the difference of the pelvic stiffness of internal fixation methods by sacroiliac screws with anterior symphyseal plating for different displaced vertically unstable pelvic fracture. Methods：Three out of eight pelvic specimens of cadavers were measured as normal group.then vertically unstable pelvic fractures were produced, and the biomechanical stiffness of internal fiction by sacroiliac screws with four hole LC- DC symphyseal plate was tested and compared in the different reductions placement （low displace group and high displace group）, the vertical and horizontal displacements of the sacroiliac joint and pubic symphysis were measured. Results： The stability of the low displaced group was superior to that of the high displaced group in internal fiction of the anterior and posterior ring for vertically unstable pelvic fracture. Conclusions：The displacement of the sacroiliac joint less than 4mm is important in order to enhance the pelvic biomechanical stability.