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皮下钉棒系统改良置钉法治疗Tile B型骨盆骨折的临床观察
Hits: 2118   Download times: 1153   Received:June 19, 2016    
作者Author单位UnitE-Mail
吴晓天 WU Xiao-tian 复旦大学附属中山医院青浦分院骨科, 上海 201700 Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China  
陈农 CHEN Nong 复旦大学附属中山医院青浦分院骨科, 上海 201700 Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China alpijuv@163.com 
潘福根 PAN Fu-gen 复旦大学附属中山医院青浦分院骨科, 上海 201700 Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China  
刘佐庆 LIU Zuo-qing 复旦大学附属中山医院青浦分院骨科, 上海 201700 Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China  
何小健 HE Xiao-jian 复旦大学附属中山医院青浦分院骨科, 上海 201700 Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China  
期刊信息:《中国骨伤》2017年30卷,第3期,第208-212页
DOI:10.3969/j.issn.1003-0034.2017.03.004


目的:探讨皮下钉棒系统改良置钉法治疗Tile B型骨盆骨折的可行性及临床疗效。

方法:自2014年6月至2015年8月选择性应用钉棒系统改良经髂前下棘和耻骨结节置钉治疗14例Tile B型骨盆骨折,男8例,女6例;年龄23~65岁,平均42岁。观察患者的手术时间、术中出血量、骨折愈合情况及术后并发症,并采用Matta复位标准及Majeed功能评分进行疗效评价。

结果:所有患者获得随访,时间8~15个月,平均10.5个月。手术时间25~45 min,平均32 min;术中出血量10~35 ml,平均18 ml.术后骨折均Ⅰ期愈合,愈合时间9~14周,平均12.5周。术后无切口感染、内固定失败及异位骨化等并发症发生。4例出现单侧股外侧皮神经损伤,1例出现单侧股神经麻痹,最终均恢复正常。Matta复位标准结果,优7例,良5例,中2例。末次随访时Majeed功能评分为(81.50±8.05)分,其中优5例,良7例,中2例。

结论:应用皮下钉棒系统改良经髂前下棘和耻骨结节置钉固定前环创伤小、复位牢靠、并发症少,是治疗Tile B型骨盆骨折一种有前景的手术方式。
[关键词]:骨盆  骨折固定术,内  钉棒系统
 
Therapeutic observation of subcutaneous pedicle screw-rod system with modified placement for Tile B pelvic fractures
Abstract:

Objective: To investigate the feasibility and therapeutic effect of subcutaneous pedicle screw-rod system with modified placement in treatment of Tile B pelvic fractures.

Methods: From June 2014 to August 2015,14 patients with Tile B pelvic fractures were treated by subcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle. There were 8 males and 6 females,aged from 23 to 65 years with an average of 42 years. Operative time,intraoperative blood loss,fracture healing and postoperative complication were observed and clinical effects were evaluated by Matta reduction standard and Majeed score.

Results: All patients were followed up from 8 to 15 months with an average of 10.5 months. Operative time was 25 to 45 min with an average of 32 min;intraoperative blood loss was 10 to 35 ml with an average of 18 ml. All fractures got primary healing and healed time was 9 to 14 weeks with an average of 12.5 weeks. No postoperative incision infection,internal fixation failure and ectopic ossification were found,4 cases occurred unilateral lateral femoral cutaneous nerve injury and 1 case occurred unilateral femoral nerve paralysis,but all restored finally. According to Matta criteria,reduction was excellent in 7 cases,good in 5 cases,fair in 2 case. According to Majeed score system,the functional evaluation at last follow-up was excellent in 5 cases,good in 7 cases,fair in 2 cases with the average score of 81.50±8.05.

Conclusion: Subcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle have advantages of strong reduction,less trauma and complications,and is a promising surgical method in the treatment of Tile B pelvic fractures.
KEYWORDS:Pelvis  Fracture fixation,internal  Pedicle screw-rod system
 
引用本文,请按以下格式著录参考文献:
中文格式:吴晓天,陈农,潘福根,刘佐庆,何小健.皮下钉棒系统改良置钉法治疗Tile B型骨盆骨折的临床观察[J].中国骨伤,2017,30(3):208~212
英文格式:WU Xiao-tian,CHEN Nong,PAN Fu-gen,LIU Zuo-qing,HE Xiao-jian.Therapeutic observation of subcutaneous pedicle screw-rod system with modified placement for Tile B pelvic fractures[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(3):208~212
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