改良Stoppa入路的内固定术与外固定架治疗骨盆前环骨折的疗效比较

Comparison of the efficacy between internal fixation via modified Stoppa approach and external fixator in the treatment of pelvic fracture

目的比较改良Stoppa入路的内固定与外固定架治疗骨盆前环骨折的临床疗效。方法选择2012年1月~2016年6月在我院治疗的骨盆前环骨折患者80例的临床资料进行回顾性分析。其中40例患者采用外固定架治疗为外固定架组,40例患者采用改良Stoppa入路内固定治疗为内固定组。比较两组骨折复位质量、临床疗效、手术切口长度、平均手术时间、平均术中出血量、骨折愈合时间、并发症发生率。结果内固定组平均手术切口长度较外固定组长,术中出血量较外固定组多,差异有统计学意义(P<0.05)。内固定组骨折复位满意率为100.0%,显著高于外固定组,差异有统计学意义(P<0.05)。内固定组临床疗效显著优于外固定组,差异有统计学意义(P<0.05)。内固定组骨折愈合时间显著较外固定组短,差异有统计学意义(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论改良Stoppa入路的内固定治疗骨盆前环骨折与外固定架比较创伤较大,但骨折复位质量更好,临床疗效更佳。

Objective To compare the clinical efficacy between internal fixation via modified Stoppa approach and ex- ternal fixator in the treatment of pelvic fracture. Methods The clinical data of 80 patients with pelvic fracture of the anterior ring treated in our hospital from January 2012 to June 2016 were retrospectively analyzed. 40 patients underwent external fixation and were chosen as external fixation group, and 40 patients underwent modified Stoppa approach for internal fixation and were selected as the internal fixation group.The fracture reduction quality, clinical efficacy,the length of the incision, the average operative time, the average intraoperative blood loss, the time of fracture healing and the incidence of complications were compared between the two groups. Results The average length of the incision in the internal fixation group was longer than that in the external fixation group, and the amount of bleeding in the internal group was more than that of the external fixation group, the difference was statistically significant （P〈0.05）. The satisfaction rate of fracture reduction in internal fixation group was 100.0%, which was significantly higher than that in external fixation group, the difference was statistically significant（P〈0.05）. The clinical curative effect of the internal fixation group was significantly better than that of the external fixation group（P〈0.05）.The time of fracture healing in the internal fixation group was significantly shorter than that in the external fixation group,and the difference was statistically significant（P〈0.05）. There was no significant difference in the incidence of complications between the two groups（P〉 0.05）. Conclusion The internal fixation with modified Stoppa approach is superior to the external fixator in the treatment of pelvic fracture of the anterior ring, but the fracture reduction quality and the clinical curative effect of the internal fixation are better.