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改良Stoppa入路手术治疗双侧耻骨支骨折
Hits: 2147   Download times: 1515   Received:November 16, 2014    
作者Author单位UnitE-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  
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  
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  
赵凤东 ZHAO Feng-dong 浙江大学附属邵逸夫医院, 浙江 杭州 310016  
范顺武 FAN Shun-wu 浙江大学附属邵逸夫医院, 浙江 杭州 310016  
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


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
 
Modified Stoppa approach in treatment of bilateral pubic branch fractures
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
 
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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