经皮微创螺钉内固定治疗骨盆环骨折脱位的临床疗效

Clinical efficacy of minimally invasive percutaneous screw fixation in treatment of pelvic ring fracture and dislocation

目的探讨经皮微创螺钉内固定治疗骨盆环骨折脱位的临床疗效。方法笔者自2013-01—2016-04诊治45例(113处)骨盆环骨折脱位;均于伤后3~10 d行经皮微创技术置入骶髂关节螺钉,评价其术后疗效。结果所有患者均获得随访3~24个月,平均9个月。随访期间未发现复位丢失情况,骨折均一期愈合,愈合时间2~4个月,平均3.3个月。1例术后出现骶神经损伤症状,经取出内固定后症状消失。末次随访疗效按照Majeed功能评定标准评定:优35例,良7例,可3例,优良率93.3%。所有患者均无内固定脱落及折断。结论经皮微创螺钉内固定治疗骨盆环骨折脱位较传统切开复位钢板内固定,具有骨折愈合时间短、功能优良、切口美观、术中出血量少、住院时间短、术后卧床时间短、功能复恢情况良好等优点,能有效降低术后并发症的发生率。

Objective To investigate the clinical efficacy of minimally invasive percutaneous screw fixation for pelvic fracture dislocation. Methods One hundred and thirteen fracture and dislocation of pelvic rings in 45 patients were diagnosed and treated between January 2013 and April 2016. The minimally invasive percutaneous screw fixation of pelvic ring fractures was performed 3-10 d after the injury. Results All patients were followed for 3-24 months（average 9 months）. No loss of reduction was found during the follow-up period. Fracture healed at first stage, healing time was 2-4 months（average of3.3months）. One case presented with sacral nerve injury symptoms after operation, and the symptoms disappeared after removal of the internal fixation. At the last follow-up,the pelvic function was assessed according to the Majeed scoring criteria. The results were excellent in 35 cases, good in 7 cases, and fair in 3 cases with an excellent and good rate of 93.3%.All patients had no internal fixation shedding and fracture. Conclusion Compared with traditional open reduction and plate fixation, minimally invasive percutaneous screw fixation technology in pelvic ring fractures and dislocations has advantages of short fracture healing time, excellent artistic incision, less blood loss, shorter hospital stay, short postoperative bed time and good function recovery, which can effectively reduce the incidence of post-operative complications.