| C形臂X线透视下经皮空心螺钉微创内固定治疗骨盆前后环骨折 |
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投稿时间：2013-08-28
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| 作者 | Author | 单位 | Address | E-Mail |
| 黄光平 |
HUANG Guang-ping |
简阳市人民医院骨科, 四川 简阳 641400 |
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| 戢勇 |
JI Yong |
简阳市人民医院骨科, 四川 简阳 641400 |
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| 赖伟 |
LAI Wei |
资阳市雁江区人民医院, 四川 资阳 641300 |
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| 唐旭 |
TANG Xu |
简阳市人民医院骨科, 四川 简阳 641400 |
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| 吴国勇 |
WU Guo-yong |
简阳市人民医院骨科, 四川 简阳 641400 |
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| 田鹏 |
TIAN Peng |
简阳市人民医院骨科, 四川 简阳 641400 |
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| 项舟 |
XIANG Zhou |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital Affiliated to Sichuan University, Chengdu 610041, Sichuan, China |
513973904@qq.com |
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| 期刊信息：《中国骨伤》2014年，第27卷，第4期，第345-348页 |
| DOI：10.3969/j.issn.1003-0034.2014.04.019 |
| 基金项目: |
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中文摘要:
目的：探讨在C形臂X线透视下经皮空心螺钉微创固定治疗骨盆前后环骨折的效果及相关注意事项。
方法：2010年6月至2012年6月，采用C形臂X线透视下经皮微创空心螺钉内固定方法治疗骨盆前后环不稳定骨折19例，男13例，女6例；年龄22～58岁，平均41岁；车祸伤11例，高处坠落伤8例。单纯前环骨折3例，前后环均骨折16例，其中骶髂关节脱位9例，骶骨骨折7例，髂骨骨折2（1例累及骶管）.根据Tile分型：C型15例，B型4例。观察内容包括术中失血量、 手术时间、术后骨折复位情况、并发症、功能恢复情况等，固定方法包括骶髂螺钉固定、耻骨支空心钉固定、耻骨联合分离空心钉固定。
结果：解剖复位10例，满意复位8例，不满意复位1例。骨折愈合时间8～12周，平均10周，无伤口感染、骨折不愈合发生。根据Majeed功能评价：优12例，良6例，可1例。
结论：C形臂X线透视下经皮空心螺钉微创内固定治疗骨盆骨折具有创伤小、术中失血少、手术并发症发生率低、固定可靠、无须输血、可以早期功能活动等优点，能很好地重建骨盆环的稳定性，但是对术者的技术要求较高，应有充分的术前准备。 |
| 【关键词】骨盆 骨折 骨折固定术 |
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| Percutaneous screw fixation for the treatment of pelvic fractures under C-arm fluoroscopy |
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ABSTRACT
Objective: To investigate the applications of percutaneous screw fixation for the treatment of pelvic fractures and its related surgical considerations.
Methods: From June 2010 to June 2012,19 patients with pelvic fractures were treated with percutaneous hollow screws. There were 13 males and 6 females,with an average age of 41 years(ranged from 22 to 58 years). Fractures were caused by traffic accidents in 11 cases,by falling down from high place in 8 cases. Based on the Tile classification,there were 15 cases of Tile C type and 4 case of Tile B type. The indexes such as screw inserting time,intraoperative blood loss,complications,functional recovery and reduction conditions were observed. Fixation methods included sacroiliac screws,cannulated screw fixation of the pubic ramus and cannulated screw fixation of the pubic symphysis separation.
Results: Anatomical reduction achieved in 7 cases,satisfactory reduction 11 cases,and unsatisfactory reduction 1 case. Union time of fracture union ranged from 8 to 12 weeks(mean 10 weeks). Wound infection,ununion of fracture and nerve injuries were not found. According to the Majeed standards,12 patients obtained an excellent results,6 good and 1 fair.
Conclusion: Percutaneous screw fixation for the treatment of pelvic fractures under fluoroscopy has several advantages such as less trauma,less blood loss,fewer rates of complications,reliable fixation and no blood transfusion,which can reconstruct the stability of the pelvic ring,but it needs adequate preoperative preparation and high requirements for the surgeon. |
| KEY WORDS Pelvis Fractures Fracture fixation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄光平,戢勇,赖伟,唐旭,吴国勇,田鹏,项舟.C形臂X线透视下经皮空心螺钉微创内固定治疗骨盆前后环骨折[J].中国骨伤,2014,27(4):345~348 |
| 英文格式: | HUANG Guang-ping,JI Yong,LAI Wei,TANG Xu,WU Guo-yong,TIAN Peng,XIANG Zhou.Percutaneous screw fixation for the treatment of pelvic fractures under C-arm fluoroscopy[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(4):345~348 |
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