前环皮下内固定治疗骨盆前环损伤的研究进展
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作者Author单位AddressE-Mail
崔栋清 CUI Dong-qing 山西医科大学第二医院骨科, 山西 太原 030001 Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China  
陈斌 CHEN Bin 山西医科大学第二医院骨科, 山西 太原 030001 Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China  
孙海钰 SUN Hai-yu 山西医科大学第二医院骨科, 山西 太原 030001 Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China shy1995@126.com 
期刊信息:《中国骨伤》2024年,第37卷,第5期,第530-534页
DOI:10.12200/j.issn.1003-0034.20230637
基金项目:
中文摘要:前环皮下内置外固定架(internal fixation,INFIX)作为目前骨盆前环损伤微创固定的代表之一,该技术的置钉点位于髂前下棘螺钉,以向外30°、向后20°的角度拧入,并且注意螺钉头应位于深筋膜上方与骨面保持20~25 mm的安全距离。其改良版本有增加耻骨结节螺钉的3钉或4钉INFIX、单侧INFIX、短杆INFIX以及双INFIX,这些改良使其稳定性进一步增强。解剖上股外侧皮神经(lateral femoral cutaneous nerve,LFCN)相对容易受损,术中要格外注意。生物力学稳定性相较于外固定架有着优势,并且应用之灵活,不局限于耻骨支骨折、联合分离等,在前后环联合固定中也扮演着重要角色可联合后路骶髂螺钉、髂腰固定等。在儿童、妊娠期妇女、存在皮下连接杆禁忌等人群中也有报道并取得了不错的临床效果。加之目前机器人、复位架等技术的应用,极大降低了复位难度,提高了闭合复位质量,令其在复杂骨盆骨折中也能够进行固定。该技术复位质量高,有着与传统钢板等相当的疗效,常见并发症是LFCN损伤,术中仔细暴露、调整内固定的位置和深度,可有效避免该并发症。
【关键词】内置外固定架  骨盆前环损伤  骨盆骨折  综述
 
Progress of anterior subcutaneous internal fixation in the treatment of anterior pelvic ring injury
ABSTRACT  Anterior subcutaneous internal fixation (INFIX) is one of the current representatives of minimally invasive fixation of injuries to the anterior pelvic ring. The nail insertion point of this technique is located at the anterior inferior iliac spinous screw,with an angle of 30° outward and 20° backward. Screw in at an angle,and note that the screw head should be above the deep fascia and maintain a safe distance of 20 to 25 mm from the bone surface. Its improved versions include 3 or 4 nails INFIX with added pubic tubercle screws,unilateral INFIX,short-rod INFIX,and double INFIX. These improvements further enhance stability. The lateral femoral cutaneous nerve (LFCN) is relatively easy to be damaged during anatomy,so special attention should be paid during the operation. Biomechanical stability has advantages over external fixation,and its application is flexible. It is not limited to pubic ramus fracture,symphyseal separation,etc. It also plays an important role in combined anterior and posterior ring fixation. It can be combined with posterior sacroiliac screws,iliac lumbar screws,etc. Fixed etc. Good clinical results have also been reported in children,pregnant women,and people with contraindications for subcutaneous connecting rods. In addition,the current application of robots,reduction frames and other technologies has greatly reduced the difficulty of reduction and improved the quality of closed reduction,making it possible to fix complex pelvic fracture. This technique has high reduction quality and is as effective as traditional steel plates. A common complication is LFCN injury. Careful exposure and adjustment of the position and depth of internal fixation during surgery can effectively avoid this complication.
KEY WORDS  Internal fixation(INFIX)  Anterior pelvic ring injury  Pelvic fracture  Review
 
引用本文,请按以下格式著录参考文献:
中文格式:崔栋清,陈斌,孙海钰.前环皮下内固定治疗骨盆前环损伤的研究进展[J].中国骨伤,2024,37(5):530~534
英文格式:CUI Dong-qing,CHEN Bin,SUN Hai-yu.Progress of anterior subcutaneous internal fixation in the treatment of anterior pelvic ring injury[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(5):530~534
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