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经皮空心螺钉治疗累及骨盆环骨折21例临床分析(1)
http://www.100md.com 2011年4月1日 严谦,胡旺阳,万泉
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     [摘要] 目的:评价C型臂引导下经皮空心螺钉治疗累及骨盆环骨折的临床安全性及疗效。方法:回顾分析应用经皮空心螺钉治疗骨盆环骨折21例,空心螺钉直径均为6.5 mm。单纯前环单侧骨折4例、双侧骨折5例;前后环均破坏中,一侧骶骨骨折脱位合并同侧或对侧耻骨上下支骨折7例,合并耻骨联合分离2例,合并双侧耻骨上下支骨折3例。骶骨骨折脱位除1例用2枚螺钉外,其余均用1枚螺钉固定,耻骨上支用1枚螺钉,耻骨联合分离用1枚螺钉。结果:手术时间20~50 min,平均30 min,术后21例均获得随访,时间1~14个月,平均10个月。所有患者均无医源性神经损伤,除1例骶髂关节骨折脱位合并耻骨联合分离螺钉欠佳外,其余螺钉位置良好,未见螺钉移位现象。该例患者出现生理负荷下骶髂部疼痛,行走有跛行。结论:C型臂X线机引导下经皮空心螺钉治疗累及骨盆环骨折,是一种安全、有效、微创的方法。

    [关键词] 骨盆环骨折; C型臂X线机; 经皮; 空心螺钉

    [中图分类号] R683.3 [文献标识码] A [文章编号] 1671-7256(2011)02-0156-04

    doi:10.3969/j.issn.1671-7256.2011.02.010

    Clinical study of percutaneous cannulated screw fixation

    for pelvic ring fracture: an analysis of 21 cases

    YAN Qian, HU Wang-yang, WAN Quan

    (Department of Orthopedics, Peoples Hospital of Maanshan, Maanshan 243000, China)

    [Abstract] Objective: To evaluate the clinical safety and efficacy of percutaneous cannulated screw guided by C-arm X-ray machine in the management of pelvic ring fractures. Methods: 21 cases suffered pelvic ring fracture were retrospectively analyzed, who accepted percutaneous cannulated screws fixation. The diameter of hollow screw was 6.5 mm. There were 4 cases suffered anterior ring fracture of unilateral, 5 cases suffered bilateral fractures, 7 cases suffered unilateral sacral fracture-dislocation combined with ipsilateral or contralateral superior and inferior pubic fracture, 2 cases suffered symphysiolysis of symphysis pubis, 3 cases suffered bilateral upper and lower pubic fracture. Apart from one case of sacral fracture-dislocation used two screws on the operation, the rest of cases were fixed with one screw, superior ramus of pubis used one screw, sacral fracture-dislocation used one screw. Results: The operating time was 20-50 minutes, averaging of 30 minutes. All of cases were followed up for 1-14 months, averaging of 10 months. There were no iatrogenic nerve injury happened in patients, however, one screw in the case of sacroiliac joint fracture-dislocation combined with diastasis of symphysis pubis displaced, other screws were fixed in good location ......

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