改良Starr架复位与切开复位内固定治疗骨盆骨折的对比研究

Comparative Study on the Treatment of Pelvic Fractures With Improved Starr Frame Reduction and Open Reduction and Internal Fixation

目的 比较改良Starr架辅助复位、微创内固定和切开复位内固定用于骨盆骨折的效果。方法 选取2019年1月—2022年11月惠州市第一人民医院收治的骨盆骨折患者30例为研究对象,依据随机数字表法分为微创手术组(改良Starr架复位、微创内固定)和传统手术组(切开复位内固定),各15例。比较两组手术时间、术中出血量及并发症情况;采取Matta标准评估两组术后骨折复位质量,采取Majeed功能评分系统和Gibbons骶神经损伤分级评估两组术后临床功能与神经功能。结果 微创手术组的手术时间长于传统手术组(P <0.05),术中出血量低于传统手术组(P <0.05)。两组均未产生切口感染、内固定松动、断裂以及复位丢失等各类并发症。两组的骨折复位、临床功能优良率相比,差异无统计学意义(P> 0.05)。微创手术组2例术前存在神经受损,术后1例完全恢复,1例未恢复;传统手术组1例术前存在神经受损,术后未恢复。结论 改良Starr架辅助复位、微创内固定和切开复位内固定相比创伤小,出血量低,是骨盆骨折患者一个更好的治疗选择。

Objective To compare the effects of improved Starr frame assisted reduction,minimally invasive internal fixation,and open reduction internal fixation for pelvic fractures.Methods A total of 30 patients with pelvic fractures admitted to Huizhou First People's Hospital from January 2019 to November 2022 were selected as the research subjects.They were randomly divided into a minimally invasive surgery group(modified Starr frame reduction and minimally invasive internal fixation) and a traditional surgery group(open reduction and internal fixation),with 15 patients each.The surgical time,intraoperative bleeding,and complications of the two groups were compared.The Matta standard was used to evaluate the quality of postoperative fracture reduction in both groups,and the Majeed functional scoring system and Gibbons sacral nerve injury grading were used to evaluate the clinical and neurological functions of the two groups after surgery.Results The surgical time of the minimally invasive surgery group was longer than that of the traditional surgery group(P<0.05),and the intraoperative blood output was lower than that of the traditional surgery group(P<0.05).Both groups did not experience various complications such as incision infection,loose internal fixation,fracture,and loss of reduction.There was no difference in the fracture reduction and clinical functional excellence rates between the two groups(P>0.05).Two patients in the minimally invasive surgery group had nerve damage before surgery,one patient fully recovered after surgery,and one patient did not recover;One case in the traditional surgical group had preoperative nerve damage but did not recover after surgery.Conclusion Improved starr frame assisted reduction,minimally invasive internal fixation,and open reduction internal fixation have less trauma and lower bleeding,making them a better treatment option for patients with pelvic fractures.