经皮空心螺钉固定技术治疗垂直旋转不稳定骨盆骨折的疗效评价

Evaluation of Percutaneous Screws in Treatment of Rotationally and Vertically Unstable Pelvic Fracture

目的评价经皮空心螺钉固定技术治疗垂直旋转不稳定骨盆骨折可行性和疗效。方法共收治垂直旋转不稳定骨盆骨折37例，经骨盆固定、抗休克处理，待全身情况稳定后均行经皮空心螺钉固定术。结果本组均获随访，平均随访时间为21个月（12—48个月），所有骨折均在6个月内愈合。疗效按Matta评价标准：优23例，良12例，可2例；功能按Majeed评分标准：优26例，良11例。结论经皮空心螺钉固定技术治疗垂直旋转不稳定骨盆骨折能矫正畸形，重建骨盆环稳定性，且具有固定牢固、创伤小、切口小、出血少、手术时间短等优点，是值得推广应用的治疗方式。

Objective To discuss the feasibility and effect of the percutaneous screws in treatment of rotationally and vertically unstable pelvic fracture. Methods Thirty seven patients with rotationally and vertically unstable pelvic fractures were treated in our department. All pelvic fractures were treated with temporary external fixation after hospitalization,and then treated with percutaneous screw fixation when general conditions were suitable for operation. Results The mean follow-up was 21 months （from 12 to 48 months）. All the fractures healed within 6 months. According to the Matta evaluation,the results were excellent in 23 cases,good in 12 cases,fair in 2 cases. According to the Majeed evaluation, the results were excellent in 26 cases,good in 11 cases. Conclusion The pereutaneous screws in treatment of rotationally and vertically unstable pelvic fracture could correct the deformities and reconstruct the stability of the pelvic ring. There are some advantages including better bony stability,minimal invasion of compromised soft tissue and limited blood loss. The technology is a practical technique which can be widely used to treat vertical unstable pelvic fractures.