微创骶髂螺钉经皮固定结合外固定支架治疗复杂性骨盆骨折临床分析

Analysis of percutaneous iliosacral screws and external supporting flame fixation for complexity pelvic fracture

目的探讨微创骶髂螺钉经皮加外固定支架冶疗复杂性骨盆骨折的临床疗效,评估其安全性和稳定性。方法2005年11月-2009年5月收治复杂性骨盆骨折患者19例,在C型臂X线机的引导下和肌电图监测下经皮穿刺导针,测量长度后再选择合适中空螺钉内固定骶髂螺钉和外固定支架固定骨盆前环。外固定支架取出平均时间2个月。结果19例随访6-48个月,平均随访24个月。X线显示骨折平均愈合时间为9个月。无感染及神经损伤并发症。参照Matta评分标准[1]进行评价,获优13例,良6例,优良率100%。结论微创骶髂螺钉经皮固定治疗复杂性骨盆骨折具有创伤小、出血少、痛苦小、住院时间短及恢复快等优点。术中应用C-臂定位准确,结合神经肌电图监测,能提高手术的安全性;结合外固定支架固定前环,能明显提高固定的稳定性。

Objective To explore technical effect with sacroilial screw and extennal fixation of minimally invasive treatment in the management of complex pelvic fracture,and to explore its safety and stability.Methods 19 cases with complexity pelvic fracture were collected from September 2005 to May 2009 in our department,with the guidance of the C-arm and the monitoring of electromyography,after measured the length,with the sacvosial joint hollow screw internal fixation and external fixation for the treatment.The average time of remove the external fixation was 2 months.Results After 6-48 months following-up in 19 patients （average 24 months）,the average healing time of the fracture was 9 months,there was no complications such as infection and nerve injury.According to the Matta grading system,the results were excellent in 16 cases,good in 3 cases;the excellent and good rate was 100﹪.Conclusion perctuaneous sacroilial screw fixation is a useful method in treatment of complexity pelvic fracture,which has superiority of minimal trauma,less bleeding,light pain and quick recovery.