两种固定方法治疗耻骨联合分离的疗效比较

COMPARISON ON EFFICACY OF TWO FIXATIONS FOR SYMPHYSIS PUBIS DIASTASIS

目的 对比分析“M”型接骨板联合外固定支架与重建接骨板治疗耻骨联合分离的临床疗效。方法将2010年1月—2015年1月期间采用“M”型接骨板联合外固定支架固定耻骨联合分离的患者29例纳入A组,其中男15例,女14例,平均年龄41.94岁。B组采用重建接骨板固定29例,男16例,女13例,平均年龄39.10岁。术前ISS评分：A组（33.28±11.15）分,B组（31.40±12.12）分。按Tile分型：A组B型11例,C型18例：B组B型13例,C型16例。分别记录手术时间、出血量、骨折愈合时间、Majeed功能评价等数据,比较两种固定方法的临床疗效。结果 58例患者均获随访5-11个月,平均8.6个月。根据Majeed评分评价术后髋关节功能恢复：A组为（86.37±8.14）分,优良率97%;B组为（80.20±9.06）分,优良率86%。结论 采用“M”型接骨板联合外固定支架治疗耻骨联合损伤使骨盆前环具有多向稳定,固定可靠,减少并发症,有利于患者术后功能恢复,疗效优于重建接骨板。

Objective To compare the efficacy of the ＂M＂ reconstruction plate combined with external fixator and reconstruction plate in the treatment of symphysis pubic diastasis. Methods Twenty - nine patients were treated with the ＂M＂ reconstruction plate combined with external fixator（ group A） ,including 15 males and 14 females,at mean age of 41.94 years and Twenty - nine patients were treated with reconstruction plate（ group B）, including 16 males and 13 females,at mean age of 39.10 years in treatment symphysis pubic diastasis from January 2010 to January 2015. Preoperative mean injury severity score（ ISS） was 33.28 points in group A and 31.4 points in group B. According to Tile classification, group A had eleven patients with type B and eighteen patients with type C injuries,and group B had thirteen patients with type B and sixteen patients with type C injuries. The two internal fixations were compared in aspects of operation time, intraoperative blood loss, fracture heeling time and postoperative Majeed function score. Results All patients.were followed up for 5 - 11 months（average 8.6 months）. According to Majeed standard,group A scored （86.37 ± 8. 14） points,with excellence rate of 97% and group B scored （80. 20 ± 9.06） points, with excellence rate 86 %. Conclusions It has advantages in management of syrnphysis pubic diastasis for the ＂M＂ reconstruction plate combined with external fixator in the treatment of symphysis pubic diastasis,which provide the pelvis multidireetional stability, reduces complications and benefits functional resoration postoperatively and is more effective than reconstruction plate in the treatment of symphysis pubic diastasis.