C型骨盆骨折的手术内固定治疗

Surgical Treatment of Severe Unstable Pelvic Fractures

目的 探讨开放复位内固定治疗严重不稳定骨盆骨折的疗效。方法 对 2 8例严重不稳定骨盆骨折病人采用切开复位重建钢板内固定和C型臂X线机或CT引导下经皮拉力螺钉内固定和TSRH系统固定。结果 2例浅表感染 ,1例神经损伤 ,随访 3～ 36个月 ,无骨折不愈合 ,复位按照Matta标准 :优 2 3例 ,良 3例 ,可 2例。优良率 92 86 %。结论 对严重不稳定骨盆骨折病人采用切开复位重建钢板内固定和C型臂X线机或CT引导下经皮拉力螺钉内固定是较好的选择 ,可以使病人早期康复。

Objective To study effects of open reduction and internal fixation to severe unstable pelvic fractures.Methods Twenty eight patients with C type unstable pelvic fractures were treated by open reduction and internal fixation using reconstruction plates and being combined with C arm or CT guided percutaneous screw fixation or TSRH system fixation.Results Complications included of surface infection in 2 cases,nerve injury in 1 case.All patients were followed up for an average of 19 5 months(range,3～36 months).There was no case of nonunion of either the anterior or posterior fracture.According to Matta criteria,overall there were 23 excellent,3 good,2 fair reduction.Ninety two point eighty six percent of all reductions were excellent or good.Conclusion The results are satisfied if severe unstable pelvic fractures are treated by open reduction and internal fixation using reconstruction plates and C arm or CT guided percutaneous screw fixation.C arm or CT guided fixation of unstable pelvic fractures minimizes blood loss and allows early mobilization of the patients.