闭合复位内固定联合外固定架治疗不稳定骨盆骨折

目的:探讨经皮螺钉内固定联合外固定架治疗不稳定骨盆骨折的临床效果。方法:自2006年4月至2009年5月,采用闭合复位内固定联合外固定架治疗29例旋转不稳定型骨盆骨折患者,男19例,女10例;年龄19～53岁,平均31岁。按照Tile分型:C1型17例,C2型12例。术后采用Tornetta标准和Majeed功能评分进行疗效评价。结果:29例患者均获随访,时间10～24个月,平均16个月。术后无神经损伤及盆腔脏器损伤等并发症发生,伤口愈合好,仅1例出现钉道口感染,换药后治愈。骨折均获骨性愈合,愈合时间为14～18周,平均16.2周。未见螺钉松动、脱出、断裂。按照Tornetta评价,优 14例,良10例,可 4例,差 1 例。末次随访Majeed评分为87.2±11.3,优16例,良9例,可4例。结论:对于不稳定C1、C2型骨盆骨折,采用闭合复位内固定联合外固定架可以取得满意的治疗效果。

Application of internal fixation combined with external fixator for unstable pelvic fracture

Objective:To invesitigate the clinical effects of percutaneous closed reduction and cannulated screw internal fixation combined with external fixation in the treatment of unstable pelvic fractures. Methods:From April 2006 to May 2009,29 patients with pelvic fractures of rotatory instability were treated with closed reduction and screw internal fixation combined with external fixation. There were 19 males and 10 females with an average age of 31 years old (ranged from 19 to 53 years). Based on the Tile classification,17 cases were type C1 and 12 case were type C2. Tornetta standard and Majeed score were used to evaluated the clinical effect after operation. Results:All patients were followed up from 10 to 24 months with an average of 16 months. There were no nerve injuries and other organ injuries,only one case of infection was found and it was cured with wound dressing. Time of fracture union was from 14 to 18 weeks with the mean of 16.2 weeks. No loosening,slippage or breakage of the screw were found. According to the Tornetta standards,14 cases obtained excellent results,10 good,4 fair and 1 poor. The Majeed score was 87.2±11.3,16 cases got excellent results,9 good and 4 fair. Conclusion:Closed reduction and screw internal fixation combined with external fixation is an effective way to treat unstable pelvic fractures with Tile type C1 and Tile type C2.