改良Stoppa入路手术治疗双侧耻骨支骨折 |
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Received:November 16, 2014
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作者 | Author | 单位 | Unit | E-Mail |
梅正峰 |
MEI Zheng-feng |
杭州市第三人民医院, 浙江 杭州 310009 |
Department of Orthopaedics, the Third People's Hospital of Hangzhou, Hangzhou 310009, Zhejiang, China |
meizhengfeng@126.com |
雷文涛 |
LEI Wen-tao |
杭州市第三人民医院, 浙江 杭州 310009 |
Department of Orthopaedics, the Third People's Hospital of Hangzhou, Hangzhou 310009, Zhejiang, China |
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黄东辉 |
HUANG Dong-hui |
杭州市第三人民医院, 浙江 杭州 310009 |
Department of Orthopaedics, the Third People's Hospital of Hangzhou, Hangzhou 310009, Zhejiang, China |
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赵琦辉 |
ZHAO Qi-hui |
杭州市第三人民医院, 浙江 杭州 310009 |
Department of Orthopaedics, the Third People's Hospital of Hangzhou, Hangzhou 310009, Zhejiang, China |
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赵凤东 |
ZHAO Feng-dong |
浙江大学附属邵逸夫医院, 浙江 杭州 310016 |
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范顺武 |
FAN Shun-wu |
浙江大学附属邵逸夫医院, 浙江 杭州 310016 |
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期刊信息:《中国骨伤》2015年28卷,第5期,第404-407页 |
DOI:10.3969/j.issn.1003-0034.2015.05.004 |
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目的:探讨改良Stoppa入路手术治疗骨盆双侧耻骨支骨折的临床疗效。
方法:自2010年1月至2014年1月,采用改良Stoppa入路手术治疗双侧耻骨支骨折患者16例,其中男11例,女5例;年龄17~59岁,平均40.5岁。按Tile骨折分类法:A型8例,B型6例,C型2例。16例中单独使用改良Stoppa入路11例,联合髂窝入路4例,联合后路1例。观察患者的手术切口长度、手术时间、术中出血量及术后并发症情况,并采用Matta影像学骨折复位评价标准和Majeed功能评分系统对骨折复位及术后功能进行评价。
结果:改良Stoppa手术入路切口长度为8~10 cm,平均9 cm;手术时间75~135 min,平均95 min;术中出血量400~900 ml,平均600 ml.16例术后均获随访,时间7~18个月,平均12.5个月。所有患者获骨性愈合,愈合时间2.7~5个月,平均3.1个月。术后无伤口化脓感染、异位骨化,无螺钉松动、钢板断裂,无腹壁疝发生。根据Matta影像学骨折复位标准,耻骨支骨折复位优9例,良6例,可1例。术后6个月Majeed功能评分,总分85.32±8.50,其中优8例,良6例,一般2例。
结论:改良Stoppa手术入路具有切口方便直接、手术视野清晰、易于复位、并发症少和恢复快等特点,是治疗双侧耻骨支骨折一个理想的手术入路。 |
[关键词]:骨盆 耻骨 骨折 骨折固定术,内 外科手术 |
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Modified Stoppa approach in treatment of bilateral pubic branch fractures |
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Abstract:
Objective:To investigate the feasibility and effectiveness of modified Stoppa approach in treatment of bilateral pubic fractures of pelvic.
Methods:The therapeutic effects of 16 patients with bilateral pubic fractures treated through the modified Stoppa approach from January 2010 to January 2014 were summarized and analyzed,involved 11 males and 5 females with an average age of 40.5 years old ranging from 17 to 59 years. According to Tile classification,there were 8 patients with type A,6 with type B and 2 with type C. For 16 pelvic fractures,the modified Stoppa approach was used exclusively 11 cases,in combination with the iliac fossa approach in 4 cases,and in combination with the posterior approach in 1 case. The operation incision length,operation time,intra-operative blood loss and postoperative complications were observed. The fracture reduction and post-operative function were assessed by Matta criteria and Majeed system respectively.
Results:The incision length of the modified Stoppa approach ranged from 8 to 10 cm (averaged in 9 cm). The operation time ranged from 75 to 135 minutes (averaged in 95 minutes). The intra-operative blood loss ranged from 400 to 900 ml (averaged in 600 m1). Sixteen patients were followed up from 7 to 18 months (averaged in 12.5 months). The fractures were all healed,the fracture healing time was 2.7 to 5 months (means 3.1 months). There were no infections,ectopic ossification,screw loosening,plate breakage and lateral ventral syndrome. According to Matta criteria for pubic fracture reduction,the result was excellent in 9 cases,good in 6,fair in 1. The Majeed function scores at 6 months after operation was 85.32±8.50;the result was excellent in 8 cases,good in 6 cases,fair in 2 cases.
Conclusion:The modified Stoppa approach has characteristics of convenience and directness of incisions,clear operation field,easy reduction,few complications and fast recovery,it is an ideal choice in surgical treatment of bilateral pubic fractures. |
KEYWORDS:Pelvis Pubic bone Fractures Fracture fixation,internal Surgical procedures,operative |
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引用本文,请按以下格式著录参考文献: |
中文格式: | 梅正峰,雷文涛,黄东辉,赵琦辉,赵凤东,范顺武.改良Stoppa入路手术治疗双侧耻骨支骨折[J].中国骨伤,2015,28(5):404~407 |
英文格式: | MEI Zheng-feng,LEI Wen-tao,HUANG Dong-hui,ZHAO Qi-hui,ZHAO Feng-dong,FAN Shun-wu.Modified Stoppa approach in treatment of bilateral pubic branch fractures[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(5):404~407 |
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