【摘要】 目的探讨Stoppa联合髂窝入路钢板内固定一期治疗不稳定性骨盆骨折的临床疗效。方法回顾性分析2009年10月至2014年5月南方医科大学附属南方医院收治的15例不稳定性骨盆骨折患者的临床资料,均采用Stoppa联合髂窝入路切开复位钢板内固定。记录手术时间、术中出血量及输血情况,应用Matta标准和Majeed评分系统对骨折复位情况和术后功能进行评价。结果平均手术时间137 min(100~480 min),平均出血量430 m L(200~1 200 m L),术中平均输悬浮红细胞3.2个单位(0~6个单位)。术后当天按照Matta标准:解剖复位8例、满意复位5例、不满意复位2例。平均随访时间14.3个月(5~38个月),均达骨性愈合,骨折愈合时间2~6个月(平均3.6个月)。末次随访时Majeed评分:优8例、良4例、可1例、差2例。1例患者术后出现会阴部脓肿,1例术后手术切口有尿液流出,伴窦道形成,对症治疗后伤口均愈合。结论 Stoppa联合髂窝入路钢板内固定一期治疗不稳定性骨盆骨折,具有操作简单、损伤较小、临床效果良好等优点。更多还原

【Abstract】 Objective To investigate the clinical effects of one-stage plate internal fixation by Stoppa with iliac fossa approaches in treatment of pelvic fractures. Methods From October 2009 and May 2014, 15 patients with unstable pelvic fractures were treated by open reduction and plate internal fixation through Stoppa with iliac fossa approaches. Operation time, intraoperative estimate blood loss volume and transfusion conditions were recorded, fracture reduction and postoperative hip functions were assessed by Matta criterion and Majeed scoring system respectively. Results The average operation time was 137 min(100 to 480 min), the average blood loss volume was 430 m L(200 to 1 200 m L), and the average red blood cell transfusion was 3.2 U(0-6 U). According to Matta criterion, 8 cases got anatomic reduction, 5 got satisfactory reduction and 2 got unsatisfactory reduction.All patients were followed up for 5 to 38 months(average, 14.3 months), and all fractures were clinicaly healed with an average period of 3.6 months(2 to 6 months). At the last follow up, Majeed scoring showed excellent in8 cases, good in 4, fair in 1 and poor in 2. There were perineal abscess in 1 case, and urine leakage accompanied with sinus formation at surgical site in 1 case, which the wound were all healed after symptomatic treatment.Conclusion One-stage plate internal fixation by Stoppa with iliac fossa approaches provides the advantages of easy manipulation, less injuries and good clinical effects for treatment of pelvic ring fractures.更多还原