经皮空心螺钉内固定与前路钢板内固定治疗不稳定性骨盆骨折疗效比较

Comparison of curative effect between percutaneous cannulated screw fixation and anterior plate fixation in unstable pelvic fractures

目的探讨经皮空心螺钉内固定与前路钢板内固定在不稳定性骨盆骨折治疗中的疗效。方法选择2013年10月至2017年1月河池市人民医院骨科收治的84例不稳定性骨盆骨折为研究对象,根据随机数表法分为观察组与对照组各42例,对照组予前路钢板内固定术治疗,观察组予经皮空心螺钉内固定术治疗,比较两组患者的围手术期指标,并在术后6个月时采用Matta评分评估骨折复位情况,采用Majeed评分评价术后功能恢复情况。结果观察组患者的手术时间、术中出血量及住院时间分别为(66.3±22.1)min、(40.4±18.5)m L、(9.8±3.5)d,均明显少于对照组的(95.5±34.9)min、(425.7±185.6)m L、(18.4±6.8)d,差异均有统计学意义(P<0.05);术后6个月随访结果显示,观察组患者的Matta评分优良率为90.48%,略高于对照组的85.71%,Majeed评分优良率为88.10%,略高于对照组的85.71%,但差异均无统计学意义(P>0.05)。结论经皮空心螺钉内固定与前路钢板内固定治疗不稳定性骨盆骨折的疗效相当,但经皮空心螺钉内固定具有手术创伤小、术中出血量少及术后恢复快的优势。

Objective To evaluate the efficacy of percutaneous cannulated screw fixation and anterior plate fixation in the treatment of unstable pelvic fractures. Methods Eighty-four patients of unstable pelvic fractures treated from October 2013 to January 2017 in Department of Orthopedics in Hechi People＇s Hospital were selected and divided into observation group and control group according to random number method, with 42 cases in each group. The control group applied anterior plate fixation for treatment, while the observation group used percutaneous cannulated screw fixation. The perioperative indicators were compared between the two groups. At 6 months after operation, the reduction was evaluated by Matta score, and postoperative recovery was evaluated using Majeed score. Results The operative time,bleeding and hospitalization time in observation group was（66.3±22.1） min,（40.4±18.5） m L,（9.8±3.5） d, significantly less than（95.5 ± 34.9） min,（425.7 ± 185.6） m L,（18.4 ± 6.8） d in the control group（P0.05）. At 6 months after surgery, the Matta score excellent rate in the observation group was 90.48%, slightly higher than 85.71% in the control group, but the difference was not statistically significant（P0.05）. The Majeed score excellent rate in observation group was 88.10% as compared with 85.71% in the control group, and the difference was not statistically significant（P0.05）. Conclusion The curative effect of percutaneous hollow screw internal fixation and anterior plate fixation in the treatment of unstable pelvic fracture is similar, and percutaneous cannulated screw fixation has advantages of less surgical trauma, less bleeding and rapid postoperative recovery.