骨盆前、后环不稳定的治疗策略

The treatment strategy of the unstable anterior and posterior pelvic ring

目的探讨骨盆前后环不稳定的治疗策略。方法对22例Tile C型骨盆前、后环不稳定患者均急诊采用股骨髁上骨牵引结合外固定架固定，病情平稳后行前、后路重建钢板联合骶髂螺钉复位内固定术治疗。结果22例均获随访，时间6～31个月。疗效根据Matta评分标准评定：优21例，良1例。根据Majeed功能评分评定：优18例，良2例，差2例。结论先早期外固定架临时固定，二期行手术内固定，手术安全、固定可靠，可早期功能锻炼及负重，是治疗骨盆前后环不稳定的有效方法。

Objective To evaluate the treatment strategy of the unstable anterior and posterior pelvic ring. Methods 22 patients with the unstable anterior and posterior pelvic ring （type C Tile fracture）were treated by the use of exter-nal fixator arid the skeletal traction through supracondyle of femur in emergency operation. After the disease stabiliza-tion, surgical treatment was performed for unstable pelvic fracture by pelvic reconstructive plates arid iliosacral screw fixation . Results 22 patients were followed up for 6 ～ 31 months. According to Matta criterion for fracture reduc-fion,the results were excellent in 21 cases arid good in 1. According to Majeed functional scoring,the results were ex-cellent in 18 cases,good in 2 and poor in 2. Conclusions The unstable anterior and posterior pelvic ring （type C Tile fracture） can be treated by the use of external fixator in the emergent treatment, with open reduction and internal fixation in late stage. The treatment strategy is a safe, effective, reliable fixation and less invasive method, and early functional exercise and early loading can be trained.