不稳定型骨盆骨折骨外固定技术的应用

External fixation in treatment of unstable pelvic fractures

目的 探讨不稳定型骨盆骨折外固定架固定术的可行性。 方法 根据骨盆不稳定型骨折的Ｔｉｌｅ 创伤分类，对不同的创伤类型应用相对应的作用力进行固定，达到消除骨盆骨折移位、稳定骨盆环的目的。 结果 本组１６ 例，１ 例合并多发肋骨骨折、血气胸，术后死亡；１ 例未随访；１４ 例获得平均１０．１ 个月随访，总优良率为８５．７％ （１２１４）。 结论 外固定术具有创伤小，操作简单，不增加副损伤等优点。对于骨盆后侧韧带保持完整的Ｔｉｌｅ Ｂ１ 、Ｂ２ 型骨折，由于外固定架与后韧带群的协同作用，因而能形成可靠固定。对同时存在垂直不稳定型的骨盆骨折，骨外固定术可稳定骨折块，减少出血，从而有利于稳定血流动力学，为早期复苏赢得时间。

Objective To investigate the possibility of external fixation in treatment of unstable pelvic fractures. Methods Different corresponding ways of the external fixation were used according to the Tile Classification of the unstable pelvic fractures so as to remove fracture displacements and stabalize the pelvic ring. Results Among 16 cases, one died after operation because of complication of rib fracture and hematopneumothorax; one missed a follow up. The follow up averaging 10.1 months was conducted for the rest 14 cases with a total excellence rate of 85.7%. Conclusions The advantages of the external fixation in the treatment of pelvic fractures lie in easy operation, minor trauma and absence of additional injuries. Thus, together with the function of the postligaments, it succeeds in a reliable fixation in Tile B 1 and Tile B 2 fractures, in which the postligaments of pelvic rear remain good. For the vertically unstable fractures, it helps stablize the fractured bones, reduce bleeding, and win a better stablization of hemodynamics. Therefore, it has a good prospect in the treatment of unstable pelvic fractures.