单纯后入路与扩大髂腹股沟入路治疗Tile C型骨盆骨折的疗效分析

Comparison of posterior approach and enlarged ilioinguinal approach in treatment of Tile C type pelvis fracture

目的回顾性分析单纯后入路与扩大髂腹股沟入路切开复位内固定治疗Tile C型骨盆骨折的临床疗效。方法 2005年1月至2009年6月共收治27例Tile C型骨盆骨折患者,其中12例采用后入路切开复位后,重建接骨板固定后环,前环不予固定;15例采用扩大髂腹股沟入路重建接骨板固定。术后均予以定期随访,从手术时间、术中出血量、切口长度、下地时间、术后髋关节功能等方面对两组的临床疗效进行比较分析。结果全部患者均获得随访,随访时间为6～24个月,平均12.6个月。全部患者均骨性愈合;单纯后入路在手术时间、术中出血量及切口长度方面均优于扩大髂腹股沟入路,差异有统计学意义(P<0.05);比较下地时间及髋部功能,差异无统计学意义(P>0.05)。结论单纯后侧入路与扩大髂腹股沟入路相比,具有创伤小、手术时间短等优点,可获得满意的临床效果。

Objective To analyze the outcomes of surgery for Tile C type pelvis fracture through posterior approach and enlarged ilioinguinal approach.Methods From January 2005 to June 2009,27 patients with Tile C type pelvis fracture were enrolled in this study.Of them,12 patients were treated through posterior approach,and then fixed posterior ring by the reconstruction plate without anterior ring fixation;15 were via enlarged ilioinguinal approach.All were regular follow - up.The effects of two approaches were compared in operation time,blood loss,and length of incision,weight-bearing time and the function of the operated hip joint.Results All 27 patiens were followed up from 6 to 24 months with an average time of 12.6 months.All got bone union.Statistical test showed difference significant between the two groups in operation time,blood loss and length of incision.The data of posterior approach was advantaged to those of enlarged ilioinguinal approach（P0.05）.No statistically significant difference was found in weight - bearing time and the function of the operated hip joint between the two groups（P0.05）.Conclusion Compared with enlarged ilioinguinal approach, posterior approach has the virtues as follows：low trauma and short operation time.Treating Tile C type pelvis fracture through posterior approach can obtain satisfactory clinical results.