外固定支架内置法治疗骨盆前环骨折的临床观察

Clinical observation of IN-FIX for treatment of the anterior pelvic ring injuries

目的观察IN-FIX(internal-fixator,外固定支架内置法)固定骨盆前环骨折的临床疗效。方法回顾性分析2014年3月-2016年9月兰州大学第二医院骨科采用IN-FIX技术复位固定18例骨盆前环骨折的临床资料。其中男性11例,女性7例;年龄22~62岁,平均44.8岁;道路交通伤11例,坠落伤5例,挤压伤2例。观察手术时间、出血量,评估骨折复位质量,通过Majeed评分系统评价功能状态和临床疗效。结果患者均获随访,随访时间6~18个月,平均10.4个月。手术时间35~50min,平均42.7min。骨折愈合时间12~18周,平均15.1周。2例出现股外侧皮神经损伤,其中1例最终恢复正常,另1例运动完全恢复,感觉恢复欠佳。1例出现术后尿频,去除内固定后恢复正常。结论 IN-FIX是治疗骨盆前环损伤的一种有效微创方法,操作简单、创伤小、疗效肯定,但应注意避免医源性损害导致的并发症。

Objective To observe the clinical effect of IN-FIX(internal fixator) in the treatment of anterior ring fracture of pelvis.Methods Eighteen patients with anterior pelvic ring fractures were fixed with IN-FIX technique from Mar. 2014 to Sep. 2016. There were 11 males and 7 females aged 22-62 years with an average of 44.8 years. There were 11 cases of road traffic injuries,5 cases of falling injuries and 2 cases of crush injuries. The operation time and amount of bleeding were observed,the quality of fracture reduction was evaluated,and the functional status and clinical efficacy was evaluated by Majeed scoring system.Results All the patients were followed up for 6-18 months(average,10.4 months).The operation time ranged from 35 to 50 minutes(average,42.7 minutes).Fracture healing time ranged from 12 to 18 weeks(average,15.1 weeks). There were 2 cases of lateral femoral cutaneous nerve injury,of which 1 case was finally restored to normal,the other 1 case was completely recovered and the feeling was poor recovery.One patient had postoperative frequency of urination and returned to normal after removal of internal fixation.Conclusion IN-FIX is an effective minimally invasive method for the treatment of pelvic anterior ring injury. It is easy to operate,less invasive and effective. However,attention should be paid to avoid complications caused by iatrogenic damage.