内固定治疗方案对复杂性骨盆骨折复位质量及肢体功能恢复的影响

Effect of internal fixation on reduction quality and limb function recovery in complex pelvic fractures

背景:外固定曾被认为是治疗复杂性骨盆骨折的金标准,但其易发生感染、骨髓炎、神经损伤等并发症。目的:探讨内固定治疗方案对复杂性骨盆骨折复位质量及肢体功能恢复的影响,分析其可能作用机制。方法:收集2015年1月至2015年6月复杂性骨盆骨折患者76例,根据固定方式不同分为观察组和对照组,每组各38例。对照组给予外固定治疗,观察组给予内固定治疗。比较两组手术相关指标、骨折复位质量、肢体功能恢复情况。结果:观察组手术时间明显短于对照组,术中出血量明显少于对照组,负重训练时间明显早于对照组(t=7.191,5.911,5.252,P<0.05)。观察组骨折复位优良率97.37%,明显高于对照组的84.21%(χ~2=3.934,P<0.05);Majeed肢体功能评分明显高于对照组(t=5.365,P<0.05);肢体功能恢复优良率94.74%,明显高于对照组的78.95%(χ~2=4.145,P<0.05)。结论:内固定治疗方案有助于减少复杂性骨盆骨折患者手术创伤,保障骨折复位质量,促进肢体功能恢复。

Background：Extemal fixation has been considered the gold standard for the treatment of complex pelvic fractures,but it is prone to complications such as infection,osteomyelitis and nerve damage.Objective：To investigate the effect of internal fixation on reduction quality and limb function recovery in complex pelvic fractures,and to analyze the possible mechanism.Methods：A total of 76 patients with complicated pelvic fractures treated surgically from January 2015 to June 2015 were enrolled in this study.They were divided into observation group and control group according to the different methods of fixation.There were 38 patients in each group.The patients in the control group were treated with external fixation,and these in the observation group were treated with internal fixation.The operative indexes,the quality of fracture reduction and the recovery of limb function were compared between the two groups.Results：The operation time of the observation group was significantly shorter than that of the control group,and the amount of bleeding during operation was significantly less than that of the control group,and the time of weight training was earlier than that of the control group （t=7.191,5.911,5.252,P〈0.05）.The excellent and good rate of reduction of the observation group was 97.37%,which was significantly higher than that of the control group （84.21%,χ^2=3.934,P〈0.05）.The Majeed limb function score of the observation group was significantly higher than that of the control group （t=5.365,P〈0.05）.The excellent and good rate of limb function recovery of the observation group was significantly higher than that of the control group （94.74% vs 78.95%,χ^2=4.145,P〈0.05）.Conclusions：The internal fixation is helpful to reduce surgical trauma in patients with complex pelvic fractures,to ensure the reduction quality of fractures and to promote the recovery of limb function.