锁定钢板固定修复侧方压缩旋转不稳骨盆环损伤:骨盆稳定性重建

Locking plate fixation repairs lateral compression rotationally unstable pelvic ring injuries: reconstruction of pelvic stability

背景:侧方压缩旋转不稳定性骨盆环损伤,固定方式尚存在一定的争议。目的:评价锁定钢板固定骨盆重建修复侧方压缩旋转不稳骨盆环损伤后的骨盆稳定性。方法:回顾性分析苏州市相城人民医院骨科2011年11月至2014年11月手术治疗且获得随访的侧方压缩旋转不稳定性骨盆环损伤患者15例。所有病例均使用万向重建锁定钢板固定,采用Matta标准评价骨折复位质量,临床疗效评判使用Majeed功能评分。结果与结论:患者15例均获12-44个月(平均24个月)随访。根据Matta评分标准:优11例,良2例,中2例,差0例,优良率为87%。固定后功能恢复根据Majeed功能评分:优9例,良3例,中1例,差1例,优良率为80%。患者15例末次随访均未发生内固定失效或复位丢失,无医源性血管神经损伤,2例合并骨盆周围潜行脱套伤(Morel-Lavallee lesion)患者行双套管持续引流后出现切口浅表感染,未发生大面积的感染及皮肤坏死,换药后治愈。结果证实,骨盆万向重建锁定钢板修复侧方压缩旋转不稳定性骨盆环损伤能够维持坚强有效的固定。对骨盆骨折合并骨盆周围软组织损伤的病例要引起足够的重视。

BACKGROUND：There are stil some controversies about lateral compression rotational y unstable pelvic ring injuries and fixed mode. OBJECTIVE：To evaluate the pelvic stability of locking plate fixation pelvic reconstruction repairing lateral compression rotational y unstable pelvic ring injuries. METHODS：We retrospectively analyzed 15 patients with unstable lateral compression rotational y unstable pelvic ring injuries treated with reconstruction locking plates fixation at Suzhou Xiangcheng People’s Hospital between November 2011 and November 2014. The Matta standard was used to evaluate the quality of fracture reduction. Clinical efficacy was evaluated by Majeed score. RESULTS AND CONCLUSION：Fifteen patients were fol owed up for 12-44 months （mean 24 months）. According to the standard of Matta, 11 cases were excel ent, 2 cases were good, 2 cases were average, 0 case poor, and the excel ent and good rate was 87%. According to Majeed functional assessment, clinical function outcomes were graded as 9 cases excel ent, 3 cases good, 1 case average, 1 case poor;excel ent and good rate was 80%. There were no patient loss of reduction and internal fixation failure among these 15 patients in the final fol ow-up. No iatrogenic neurovascular injury occurred. Incision superficial infection was detected in 2 patients with a Morel-Laval ee lesion after subjecting to double-tube continuous negative pressure drainage, and healed after wound management. A large area of infection and skin necrosis did not occur. These results confirm that pelvic universal reconstruction locking plates in repair of lateral compression rotational y unstable pelvic ring injuries can maintain a strong and effective fixation. We should pay much attention to the cases of pelvic fractures combined with soft tissue injury around the pelvis.