骨盆外支架加压联合内固定分期治疗陈旧性Young-Burgess APC Ⅱ、Ⅲ型骨盆骨折效果观察

Observation of Staged Compression by External Fixation Combined with Internal Fixation in Treatment of Type Ⅱ and Ⅲ of Old Young-Burgess APC Pelvic Fracture

目的探讨骨盆外支架加压联合内固定治疗陈旧性Young-Burgess APCⅡ、Ⅲ型骨盆骨折的效果。方法对2011年8月—2012年7月收治的5例陈旧性Young-Burgess APCⅡ、Ⅲ型骨盆骨折,一期手术采取外固定支架加压骨盆前环纠正旋转移位,2例APCⅢ型结合骨牵引纠正垂直移位,二期行内固定手术治疗。结果本组耻骨联合分离较伤后均明显改善,Matta评分评价术后骨折复位情况:优3例,良1例,可1例,术后6个月复查X线均提示骨折愈合。术后6～18个月,Majieed功能评分优3例,良2例。结论对以耻骨联合分离为表现的陈旧性Young-BurgessAPCⅡ、Ⅲ骨盆骨折,使用骨盆外支架纠正旋转移位,二期行内固定手术的方法治疗,可获得满意的复位,功能恢复较好。

Objective To explore the effect of staged compression by external fixation combined with internal fixation in treatment of type Ⅱ and Ⅲ of old Young-Burgess APC pelvic fracture.Methods A total of 5 patients with type Ⅱ or Ⅲ of Young-Burgess APC during August 2011 and July 2012 were treated with external fixation compression which could reduce rotation of pelvic ring in onestage operation,among them 2 patients with type Ⅲ of APC underwent skeletal traction for reducing vertical displacement,and internal fixation in second stage operation.Results In the group patients＇ the distances of pubic symphysis separation obviously improved after treatment,Matta score showed the postoperative fracture reduction： 3 patients were excellent,1 patient was good,and 1 patient was common.Review of x ray picture after operation for 6 months showed fracture healing.There were 3 patients with excellent and 2 patients with good by Majieed score method with 6-18 months of follow-up.Conclusion Old Young-Burgess APC Type Ⅱ and Ⅲ of pelvic fracture with pubic symphysis separation can be treated with external fixation compression which can reduce rotation of pelvic ring,and internal fixation in second stage.The method can get better reduction and satisfied function.