| 经皮微创内固定治疗不稳定骨盆骨折 |
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投稿时间：2010-03-22
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈红卫 |
CHEN Hong-wei |
义乌市中心医院骨科，浙江 义乌 322000 |
Department of Orthopaedics,the Central Hospital of Yiwu City,Yiwu 322000,Zhejiang,China |
chw6988@yahoo.com.cn |
| 赵钢生 |
ZHAO Gang-sheng |
义乌市中心医院骨科，浙江 义乌 322000 |
Department of Orthopaedics,the Central Hospital of Yiwu City,Yiwu 322000,Zhejiang,China |
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| 叶招明 |
YE Zhao-ming |
浙江大学医学院附属第二医院 |
Department of Orthopaedics,the Central Hospital of Yiwu City,Yiwu 322000,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第7期，第541-543页 |
| DOI：10.3969/j.issn.1003-0034.2010.07.021 |
| 基金项目:浙江省科技厅面上基金资助项目(2008C33017) |
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中文摘要:
目的：探讨经皮微创内固定技术治疗不稳定骨盆骨折的临床疗效。
方法：2005年1月至2009年1月，行经皮微创内固定治疗不稳定骨盆骨折48例，男31例，女17例；年龄12～66岁，平均37.8岁。致伤原因：车祸伤29例，高处坠落伤14例，挤压伤5例。骨折类型按Tile分型：B1型4例，B2型3例，C1型25例，C2型14例，C3型2例。48例患者分别采用经皮骶髂螺钉（其中耻骨支螺钉固定16例、耻骨联合螺钉固定4例）,重建钢板（其中耻骨支螺钉固定20例、耻骨联合螺钉固定8例）微创内固定治疗。术后通过X线观察患者复位情况并根据Majeed功能评分标准对疗效进行评定。
结果：48例患者均获得随访，时间12～39个月，平均17个月。未发生切口感染、血管神经损伤、内固定松动及断裂、骨不愈合等并发症。解剖复位29例，满意复位18例，复位不满意1例。根据Majeed功能评价：优29例，良15例，可4例，优良率为91.7%.
结论：经皮微创内固定治疗不稳定骨盆骨折手术创伤小，出血少，术后并发症少，骨折愈合率高，固定可靠，患者功能恢复满意，是治疗骨盆骨折的有效手段，但对操作者要求高。 |
| 【关键词】骨盆 骨折 外科手术，微创性 |
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| Treatment of unstable pelvic fractures with minimally invasive internal fixation |
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ABSTRACT
Objective: To explore the clinical effects of minimally invasive internal fixation in the treatment of unstable pelvic fractures.
Methods: From January 2005 to January 2009,the data of 48 patients with unstable pelvic fractures were retrospectively analyzed. There were 31 males and 17 females. The age ranged from 12 to 66 years with an average of 37.8 years. Among them,29 cases were caused by traffic accident,14 by fall from height and 5 by crush injury. According to Tile's classification,type B1 was in 4 cases,B2 in 3,C1 in 25,C2 in 14 and C3 in 2. All patients were treated with minimally invasive internal fixation of percutaneous reconstruction plate(including 20 cases with percutaneous pubic ramus screws fixation and 8 cases with pubic tubercle screws fixation) and percutaneous sacroiliac screws(including 16 cases with percutaneous pubic ramus screws fixation and 4 cases with pubic tubercle screws fixation). With X-ray films to observe the reduction of fractures and according to Majeed standard to evaluate the clinical effects.
Results: All patients were followed up for 12-39 months with an average of 17 months. No infection of incision,nerve injuries,loosening or breakage of the screw was found. All cases attained bone union. Anatomical reduction achieved in 29 cases,satisfactory reduction 18 cases,and unsatisfactory reduction 1 case. According to the Majeed standards,29 cases obtained excellent results,15 good and 4 fair,the rate of excellent and good was 91.7%.
Conclusion: Treatment of unstable pelvic fractures with minimally invasive internal fixation had advantages of minimal trauma,less bleeding,less postoperative complications,high bone union rate,reliable fixation and satisfactorily functional recovery after operation,but the method demanded skillful surgical techniques. |
| KEY WORDS Pelvic Fractures Surgical procedures,minimally invasive |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈红卫,赵钢生,叶招明.经皮微创内固定治疗不稳定骨盆骨折[J].中国骨伤,2010,23(7):541~543 |
| 英文格式: | CHEN Hong-wei,ZHAO Gang-sheng,YE Zhao-ming.Treatment of unstable pelvic fractures with minimally invasive internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(7):541~543 |
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