[1]石成弟,汤骏,胡炜,等.经皮空心螺钉内固定与前路钢板内固定治疗不稳定性骨盆骨折的对比研究[J].中医正骨,2013,25(06):10-13.
 SHI Cheng-di*,TANG Jun,HU Wei,et al.Comparison of percutaneous hollow screw osteosynthesis and anterior plate osteosynthesis for treatment of unstable pelvic fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(06):10-13.
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经皮空心螺钉内固定与前路钢板内固定治疗不稳定性骨盆 骨折的对比研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期数:
2013年06期
页码:
10-13
栏目:
骨盆髋臼损伤
出版日期:
2013-06-30

文章信息/Info

Title:
Comparison of percutaneous hollow screw osteosynthesis and anterior plate osteosynthesis for treatment of unstable pelvic fractures
作者:
石成弟汤骏胡炜郭晓山
温州医科大学附属第二医院,浙江 温州 325027
Author(s):
SHI Cheng-di*TANG JunHU WeiGUO Xiao-shan.*
The Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325027,Zhejiang,China
关键词:
骨盆 骨折固定术内 骨螺丝 骨板 治疗临床研究性
Keywords:
Pelvis Fracture fixationinternal Bone screws Bone plates Therapiesinvestigational
摘要:
目的:比较闭合复位经皮空心螺钉内固定及前路切开复位重建钢板内固定治疗不稳定性骨盆骨折的临床疗效及安全性。方法:回顾性分析接受手术治疗的59例不稳定性骨盆骨折患者的病历资料,采用闭合复位经皮空心螺钉内固定者31例(A组),采用前路切开复位重建钢板内固定者28例(B组)。记录并比较2组患者手术时间、术中出血量及住院时间,采用Matta骨盆骨折复位评定标准评定患者的骨盆骨折复位情况,采用Majeed骨盆骨折评价标准评定2组患者的临床综合疗效,同时记录并比较患者术后及随访期间的并发症发生情况。结果:①一般情况。A组患者手术时间[(45.60±12.50)min]、术中出血量[(25.80±5.60)mL]及住院时间[(8.60±3.40)d]均小于B组[(120.60±25.50)min,(580.50±210.20)mL,(19.30±5.20)d],差异均有统计学意义(t=14.582,P=0.000; t=14.701,P=0.000; t=9.422,P=0.000)。②骨折复位情况。A组优21例,良8例,可2例; B组优19例,良7例,可2例。2组患者骨折复位情况比较,差异无统计学意义(Z=-0.009,P=0.993)。③临床综合疗效。A组优24例,良5例,可2例; B组优22例,良5例,可1例。2组患者的临床综合疗效比较,差异无统计学意义(Z=-0.158,P=0.875)。④安全性。2组患者均未出现切口感染、医源性血管神经损伤及内固定失败等并发症。结论:经皮空心螺钉内固定和前路钢板内固定治疗不稳定性骨盆骨折的疗效及安全性相当,但前者具有手术时间短、术中出血少及术后恢复快的优势。
Abstract:
Objective:To compare the clinical curative effects and safety of closed reduction percutaneous hollow screw fixation and anterior open reduction reconstruction plate fixation in the treatment of unstable pelvic fractures.Methods:The medical records of 59 patients underwent operative treatment for their unstable pelvic fractures were analyzed retrospectively.Thirty-one patients(group A)were administrated with closed reduction and percutaneous hollow screw fixation,while 28 patients(group B)were administrated with anterior open reduction and reconstruction plate fixation.Such parameters as operation time,amounts of blood loss and hospitalization time were recorded and compared between the 2 groups; and pelvic fractures reductions of patients were evaluated according to Matta evaluation standards of pelvic fractures reductions; also the general clinical curative effects of the 2 groups were evaluated according to Majeed evaluation standards of pelvic fractures; meanwhile,the complications during postoperative and follow-up periods were recorded and compared between the 2 groups.Results:The operation time((45.60±12.50)min),amounts of blood loss((25.80±5.60)mL)and hospitalization time((8.60±3.40)d)of group A were all lower than those of group B((120.60±25.50)min,(580.50±210.20)mL,(19.30±5.20)d)respectively,and there were statistical differences between the two groups(t=14.582,P=0.000; t=14.701,P=0.000; t=9.422,P=0.000).Twenty-one patients obtained an excellent result of fracture reduction,8 good and 1 fair in group A; while 19 cases obtained an excellent result,7 good and 2 fair in group B.There was no statistical difference in fracture reduction between the 2 groups(Z=-0.009,P=0.993).Twenty-four patients obtained an excellent clinical curative effects,5 good and 2 fair in group A; while 22 cases obtained an excellent clinical curative effects,5 good and 1 fair in group B.There was no statistical difference in clinical curative effects between the 2 groups(Z=-0.158,P=0.875).No complications including incision infection,iatrogenic neurovascular injury and failed internal fixation were found in the 2 groups.Conclusion:The therapy of percutaneous hollow screw fixation is similar to the therapy of anterior plate osteosynthesis in curative effect and safety in the treatment of unstable pelvic fractures,while the former has the advantages of shorter operation time,less blood loss and quicker recovery after operation.

参考文献/References:

[1] Giannoudis PV,Tzioupis CC,Pape HC,et al.Percutaneous fixation of the pelvic ring:an update[J].J Bone Joint Surg Br,2007,89(2):145-154.
[2] Tile M.Pelvic ring fractures:should they be fixed?[J].J Bone Joint Surg Br,1988,70(1):1-12.
[3] 国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:176.
[4] Matta JM,Tornetta P 3rd.Internal fixation of unstable pelvic ring injuries[J].Clin Orthop Relat Res,1996,(329):129-140.
[5] Majeed SA.Grading the outcome of pelvic fractures[J].J Bone Joint Surg Br,1989,71(2):304-306.
[6] Matta JM,Saucedo T.Internal fixation of pelvic ring fractures[J].Clin Orthop Relat Res,1989,(242):83-97.
[7] Griffin DR,Starr AJ,Reinert CM,et al.Vertically unstable pelvic fractures fixed with percutaneous iliosacral screws:does posterior injury pattern predict fixation failure?[J].J Orthop Trauma,2006,20(1 Suppl):S30-S36.
[8] Putnis SE,Pearce R,Wali UJ,et al.Open reduction and internal fixation of a traumatic diastasis of the pubic symphysis:one-year radiological and functional outcomes[J].J Bone Joint Surg Br,2011,93(1):78-84.
[9] 石成弟,郭晓山,胡炜,等.经皮空心钉固定治疗创伤性耻骨联合分离[J].中华骨科杂志,2011,31(11):1218-1222.
[10] 余可和,洪建军,陈临炜,等.空心螺钉与重建钢板固定耻骨联合分离的生物力学稳定性比较[J].医用生物力学,2010,25(6):475-478.

更新日期/Last Update: 1900-01-01