【摘要】 目的探讨应用微创插板技术,联合外固定架固定,治疗不稳定型骨盆骨折的可行性。方法 2011年3月至2012年12月,对河南大学附属郑州市骨科医院收治的骨盆骨折病人进行筛选,按照Young与Burgess原始损伤机制分类为:侧方挤压(LC)的Ⅰ型和Ⅱ型,前后挤压(APC)的Ⅰ型纳入治疗对象,共15例,均采用微创插板固定或联合外固定架固定治疗。男11例,女4例;年龄20~62岁,平均40岁;侧方挤压(LC)的Ⅰ型5均,侧方挤压(LC)的Ⅱ型4例,前后挤压(APC)的Ⅰ型6例;耻骨上支或耻骨联合处骨折,应用微创插板螺钉固定术,后环采用经皮于双侧髂骨置入螺丝钉,用外固定架连接固定。术前摄骨盆CR片骨盆螺旋CT检查了解骨折表面及内部的细节,明确骨折情况,采用体表定位,结合C形臂引导手术。结果术中失血18~60 ml,平均40 ml;手术时间30~60 min;CR观察骨折愈合时间9~16周,平均14周;无伤口感染、骨折不愈合、神经损伤等。结论在掌握好手术适应证的前提下微创插板固定或联合外固定架治疗骨盆骨折手术,具有创伤小、手术时间、短效果好、恢复快、并发症少等优点。值得推广应用。更多还原

【Abstract】 Objective To discuss feasibility of minimal invasive surgical treatment of the pelvis fractures. Methods Twenty-six patients with pelvis fracture were treated with micro-surgical treatment. There were 15 male and 11 female with an average age of 40 years ranging from 20 to 62 years. All patients were closed fracture. 17 patients were hemi-pelvis fracture,and 9 patients were bilateral-pelvis fracture. The fracture type of posterior ring of pelvis as follows 8 patients were sacroiliac joint dislocation,and 12 patients were vertical section fracture in the outboard of the sacrum. The fracture type of anterior ring of pelvis are as follows. 9 patients were hemi-fracture of rami ossis pubisi or hemi-fracture of rami ischi,7 patients were bilateral-fracture of rami ossis pubisi or bilateral fracture of rami ischii. 6 patients were separation of symphysis pubis. Six patients accompanied with shock. Anterior ring of pelvis was fixed by lag screw via superior ramus of pubis and pubic symphysis. Posterior ring of pelvis was fixed by lag screw via sacroiliac joint or intra-sacral rod via ilium. X-ray and multi slice spiral CT of pelvis was obtained in order to understand exterior and inner details about pelvis fracture. Adopt orientation in body and inducted by C-arm digital subtracting X-ray system when operating. Results Blood loss was about 10 to 50 ml(mean 30 ml). Operation time was 30 to 50 minutes. Time of fracture union was 8 to 12 weeks(mean 11 weeks). Wound infection,ununion of fracture and nerve injuries had not been found. Conclusion Minimally invasive operation has the merit of short operation time,fine effect,soon recovering and few complications.更多还原