DSA旋转重建技术在经皮骶髂关节螺钉固定治疗骶髂关节骨折脱位中的应用

The Application of DSA Rotary Reconstruction Technique in Percutaneous Iliosacral Screw Fixation for the Treatment of Sacroiliac Joint Fracture and Dislocation

目的探讨应用数字减影血管造影技术(DSA)旋转重建技术引导经皮骶髂关节螺钉固定治疗骶髂关节骨折脱位的可行性。方法 2010年3月～2012年12月,采用DSA引导经皮置入骶髂关节螺钉治疗骶髂关节脱位患者21例。所有患者均在DSA监视下经皮置入导针和空心钉,通过DSA旋转重建技术重建钉道切线位的二维图像和螺钉在骨盆内的三维图像确保置钉位置满意。采用Matta标准和Majeed标准评价复位和功能恢复情况。结果随访6～39个月,平均16.5个月,DSA旋转重建后证实置钉满意率100%(24/24),所有患者无神经、血管并发症。复位优良率95.2%(20/21);功能恢复优良率95.2%(20/21)。结论 DSA可有效引导骶髂关节螺钉经皮置入,通过旋转重建技术可以确保螺钉置入的准确性和安全性。

Objective To explore the feasibility of applicating DSA rotary reconstruction technique in percutaneous itiosacral screw fixation for the treatment of sacroiliac joint fracture and dislocation. Methods From March 2010 to December 2012,21 patients were treated by percutaneous iliosacral screw. All the patients were under DSA monitoring. Tangent and 3D image of screws in the pelvic detecting by DSA rotary reconstruction technique to ensure that the screw＇s position is satisfied. The Matta and Majeed standard were used to evaluate the effective of reduction and functional recovery. Results All patients were followed up for 6-39 months,average 16.5 months. Screw＇s position was confirmed by DSA rotary reconstruction technique and the satisfaction rate was 100% （24/ 24）. There were no neural and vascular complications. The excellent and good rate of reduction reached 95.2% （20/ 21） and the excellent and good rate of function recovery reached 95.2% （20/21）. Conclusion DSA can effectively guide the iliosacral screws inserted percutaneously. The accuracy and safety of screw placement can be ensured by rotary reconstruction technique.