前环经皮内固定支架治疗TileB型骨盆骨折

Anterior subcutaneous internal fixation for treatment of Tile type B pelvic fractures

目的:探讨前环经皮内固定支架治疗Tile B型骨盆骨折。方法 :回顾性分析2014年4月—2017年4月经2钉椎弓根螺钉前环经皮内固定支架治疗的12例骨盆骨折患者,骨折按Tile分型:B1型3例,B2型6例,B3型3例;男7例,女5例;年龄20~65岁,平均(42.9±15.2)岁;车祸伤8例,高处坠落伤4例。记录患者术中出血量和手术时间,并观察术后并发症情况。术后功能运用Matta评定标准和Majeed评分进行评估。结果:12例患者均获得随访,随访6~20个月,平均15个月。术中出血量为(28.9±9.2)m L,手术时间为(42.6±15.3)min。骨折均愈合,无术后感染发生。Matta评定标准:优9例,良3例;Majeed评分:优7例,良5例,优良率均为100%。10例患者术后双侧髋关节术后屈曲>90°。结论:2钉椎弓根螺钉前环经皮内固定支架可以治疗Tile B型骨盆骨折并可获得满意的疗效。

Objective To evaluate the clinical outcome of anterior subcutaneous intemal fixator（ASIF） system with two pediclescrews in stabilizing Tile type B pelvic fractures. Methods： From April 2014 to April 2017, 12 cases of pelvic fractures werestabilized with the ASIF system using two pedicle screws. All cases had Tile type B fractures, including 3 cases of type B1, 6type B2 and 3 type B3. There were 7 male and 5 female cases, with the age range of 20-65 years[（42.9±15.2） years]. Causesof injury were traffic accidents（n=8） and fall from height（n=4）. Intraoperative blood loss, operation time and complications weredetected. Postoperative function evaluation was done using the the Matta standard and the Majeed score. Results： All caseswere available for follow up of 6-20 months（mean, 15 months）. Intraoperative blood loss was （28.9±9.2） mL, operation time was（42.6±15.3） min. Among them, 10 cases showed bilateral hip flexion over 90 degrees after operation. All fractures were healedand no postoperative infection occurred. According to the Matta standard, the outcome of 9 patients was excellent and 3patients were good, and according to the Majeed score, excellent results were found in 7 cases and good results in 5 cases.Conclusion： ASIF system with two pedicle screws results in high healing rate and few complications in the treatment of Tiletype B pelvic fractures.