应用微创接骨板固定技术治疗骨盆骨折

The application of minimally invasive plate osteosynthesis technique in the treatment of pelvic fractures

目的探讨应用微创接骨板固定(MIPO)技术治疗骨盆骨折的临床疗效。方法将35例骨盆骨折患者行复位后采用MIPO技术内固定治疗。记录手术时间、术中出血量、术中及术后并发症情况,评估患者术后骨折复位以及功能恢复情况。结果患者均获得随访,时间4~36个月。手术时间96~190 min,术中出血量160~380 ml。患者术中均未发生重要神经、血管损伤,术后未发生股外侧皮神经支配区域感觉异常、伤口感染、骨折不愈合、肺部感染及下肢深静脉血栓等并发症。1例术后6 d伤口发生脂肪液化,加强换药后一期愈合。术后1周根据Matta评分标准评估骨折复位情况:解剖复位16例,满意复位19例。末次随访时,根据Majeed评分标准进行功能评估:优21例,良13例,可1例,优良率97.14%。结论应用MIPO技术治疗骨盆骨折安全有效,通过间接复位减少了对骨折部位骨膜血供的影响,具有出血少、手术时间短、并发症少、术后恢复快等优点。

Objective To investigate the clinical efficacy of the minimally invasive plate osteosynthesis(MIPO)technique in the treatment of pelvic fractures.Methods The 35 patients with pelvic fractures were treated with MIPO technique after surgical reduction.The operative time,intraoperative blood loss,intraoperative and postoperative complications of all patients were observed,and the situation of postoperative fracture reduction and postoperative functional recovery of the patients were evaluated.Results All patients were followed up for 4~36 months.The operation time ranged from 96 min to 190 min,the intraoperative blood loss ranged from 160 ml to 380 ml.None of the 35 patients had important neurovascular injuries during the operation,and none of the patients had sensory abnormalities in the femoral lateral cutaneous nerve innervation area after the operation,none had complications such as wound infection,nonunion,pulmonary infection,and deep vein thrombosis of lower limbs.Fat liquefaction occurred in the wound of 1 patient at 6 d after surgery,and the wound was healed in one stage after intensive wound care.At 1 week after operation,fracture reduction was evaluated according to the Matta scoring standard:anatomical reduction in 16 cases,satisfactory reduction in 19 cases.At the last follow-up,functional evaluation was conducted according to the Majeed scoring standard:excellent in 21 cases,good in 13 cases,fair in 1 case,the excellent and good rate was 97.14%.Conclusions The application of MIPO technique in the treatment of pelvic fractures is safe and effective.Through indirect reduction,the effect on the periosteum blood supply at the fracture site is reduced.It has the advantages of less bleeding,less surgery time,few complications,and rapid postoperative recovery.