微创内固定治疗不稳定性骨盆环骨折的疗效分析

Efficacy of minimally invasive internal fixation to treat unstable fracture of pelvic ring

目的分析微创空心螺钉内固定治疗不稳定性骨盆环骨折的疗效。方法2007年6月-2010年6月，对40例不稳定性骨盆骨折，没有并发大出血、神经损伤的患者，在伤后3～5天内先给予大重量骨牵引，纠正骨折垂直移位，1周内在C臂X线透视下通过骨盆正位、人口位、出口位及闭孔斜位、髂骨斜位等位置定位准确后，微创用空心螺钉内固定骶髂关节、耻骨支、耻骨联合、髂骨。结果40例均获得随访8．24个月，骨折愈合时间为3．4．5个月，疗效评估按Majeed疗效评定标准，优良率为92．5％。结论微创空心螺钉内固定治疗不稳定性骨盆环骨折具有损伤小、出血少、固定效果好、费用低以及并发症发生率低等优点。

Objective To analyze the clinical effectiveness of minimally invasive internal fixation with cannulated screws to treat unstable fracture of pelvic ring. Methods From June 2007 to June 2010, 40 cases of patients with unstable fracture of pelvic ring , and without massive hemorrhage and nerve injury, were be given higher gross weight skeletal traction in 3-5 days after injury to correct the vertical shift, then be located by pelvic anteroposterior, inlet, outlet, ohturator foramen loxosis and ilium loxosis X-ray radiograghs under C-arm fluoroscopic guidance accurately, and fixed the sacroiliac joint, pubic ramus, pubic symphysis and ilium with cannulated screws minimally invasively in 1 week.Results All the 40 cases were followed-up 8-24 months.The time of fracture healing was 3-4.5 months.The excellent and good rates were 92.5% according the Majeed criterion of therapeutical effect. Conclusions Minimally invasive internal fixation with cannulated screws to treat unstable fracture of pelvic ring has lesser injury and hemorrhage, better effectiveness of fixation, lower incidence of complication and is inexpensive.