| 骨盆环不稳定性骨盆骨折的手术入路和内固定选择 |
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Received:June 20, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 毕大卫 |
BI Da-wei |
杭州市萧山区第一人民医院, 浙江 杭州 311200 |
The First People's Hospital of Xiaoshan, Hangzhou 311200, Zhejiang, China |
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| 祖罡 |
ZU Gang |
杭州市萧山区第一人民医院, 浙江 杭州 311200 |
The First People's Hospital of Xiaoshan, Hangzhou 311200, Zhejiang, China |
hztruegreen@163.com |
| 韩雷 |
HAN Lei |
杭州市萧山区第一人民医院, 浙江 杭州 311200 |
The First People's Hospital of Xiaoshan, Hangzhou 311200, Zhejiang, China |
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| 陈亿民 |
CHEN Yi-min |
杭州市萧山区第一人民医院, 浙江 杭州 311200 |
The First People's Hospital of Xiaoshan, Hangzhou 311200, Zhejiang, China |
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| 马海涛 |
MA Hai-tao |
杭州市萧山区第一人民医院, 浙江 杭州 311200 |
The First People's Hospital of Xiaoshan, Hangzhou 311200, Zhejiang, China |
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| 胡钢锋 |
HU Gang-feng |
杭州市萧山区第一人民医院, 浙江 杭州 311200 |
The First People's Hospital of Xiaoshan, Hangzhou 311200, Zhejiang, China |
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| 朱元 |
ZHU Yuan |
杭州市萧山区第一人民医院, 浙江 杭州 311200 |
The First People's Hospital of Xiaoshan, Hangzhou 311200, Zhejiang, China |
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| 期刊信息：《中国骨伤》2017年30卷，第3期，第213-216页 |
| DOI：10.3969/j.issn.1003-0034.2017.03.005 |
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目的：探讨在骨盆环不稳定骨盆骨折中手术入路与内固定的选择。
方法：2010年5月至 2015年5月，45例骨盆前后环不稳定患者分别采取不同的固定方法及手术入路治疗，男38例，女7例；年龄21～61岁，平均45岁；病程在2周内。按照Young-Burg分型，其中LC型23例，VS型6例，APC型16例。术前患者髋部疼痛，活动受限，摄片示骨盆环断裂骨折移位。
结果：术后患者伤口愈合佳，无相关并发症。45例患者术后获得随访，时间9～21个月，平均13 个月。术后患者髋部疼痛缓解，X线片示骨盆复位满意，骨盆环形态恢复良好。Majeed功能评分（93.5±11.6）分；结果优35例，良8例，可2例。
结论：伴有骨盆环不稳定的骨盆髋臼骨折，往往并发复合伤，手术原则既要考虑减少手术创伤，又要顾及骨折复位，特别要考虑关节内骨折复位和骨盆环的稳定性，所以往往需要切开手术入路和微创手术相结合，才能达到满意的疗效。 |
| [关键词]:骨盆 骨折 手术入路 骨折固定术，内 |
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| Choices of the internal fixation and approaches on unstable pelvic ring fractures |
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Abstract:
Objective: To discuss the suitable surgical approach and the internal fixation of unstable pelvic pelvic fractures.
Methods: From May 2010 to May 2015,45 patients with unstable pelvic fractures were treated with different approaches and fixations,including 38 males and 7 females with an average age of 45 years ranging from 21 to 61 years. The course was within 2 weeks. According to Young-Burg classification,23 patients were lateral compression injuries,6 patients were vertical shearing injuries,16 patients were anterior-posterior compression injuries. All patients had hip pain and limitation of motion,the X-rays showed the pelvic ring fracture.
Results: All wounds healed well without complications,45 cases were followed up for a mean period of 13 months(ranged 9 to 21 months). Patients with hip pain had a good postoperative pain relief. The post-operative X-rays showed the reduction was satisfied and the pelvic ring shaped well. According to Majeed standards,the final follow-up score was 93.5±11.6,35 cases got excellent results,8 were good,2 were fare.
Conclusion: The unstable pelvic and acetabular fractures are always with compound injury. Beside the reduction,to decrease the second surgery trauma should take into consideration as well,the intra-articular reduction and the stability of the pelvic were especially valued,so combined the different approach with minimal invasive technique can get good clinical result. |
| KEYWORDS:Pelvis Fractures Operative approach Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 毕大卫,祖罡,韩雷,陈亿民,马海涛,胡钢锋,朱元.骨盆环不稳定性骨盆骨折的手术入路和内固定选择[J].中国骨伤,2017,30(3):213~216 |
| 英文格式: | BI Da-wei,ZU Gang,HAN Lei,CHEN Yi-min,MA Hai-tao,HU Gang-feng,ZHU Yuan.Choices of the internal fixation and approaches on unstable pelvic ring fractures[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(3):213~216 |
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