骨折切开复位不同内固定治疗不稳定型骨盆环骨折的临床疗效观察

目的总结不稳定型骨盆环骨折的手术方法和治疗效果。方法从2005年4月～2009年11同，共手术治疗38例，其中后拄合并后壁骨折8例，横形合并后壁骨折12例，“T”形骨折10例，双拄骨折5例，前拄合并后半横形骨折3例。手术采用Kocher-Langenbeck（K-L）入路8例，髂腹股沟入路12例，延长髂股入路5例，双入路（髂腹股沟＋K-L入路）13例。结果解剖复位26例（63.3％）满意复位10例（32．7％）不满意复住2例（45％）。临床和X线优良率分别为705％和71.8％其中解剖和非解剖复位组的临床优良率分别为839％和364％（Χ^2=22．89，P〈0．01），并发症：坐骨神经不全性牵伸损伤1例（1．0％）；深部感杂2例（2.0％）。结论复位质量与疗效密切相关。骨折切开复位不同内固定治疗不稳定型骨盆环骨折可取得满意的骨折复位和治疗效。

Clinical Efficacy of Unstable Pelvic Ring Fracture with Open Reduction and Internal Fixation of Fractures of Different Treatment

Objective To summarize the unstable pelvic ring fracture of the surgical methods and treatment. Methods From April 2005- November 2009, a total of 38 cases of surgical treatment, which combined posterior wall fracture of the posterior column of 8 cases, transverse posterior wall fracture of 12 cases of the merger, ＂T＂ -shaped fracture of 10 cases, 5 cases of double-column fractures, the former column and a half after the merger transverse fracture in 3 cases. Surgery with Kocher-Langenbeck （KL） approach in 8 cases, 12 cases of ilioinguinal approach, extended iliofemoral approach in 5 cases, double-entry Road （groin ＋ K-L into the road） in 13 cases. Results The anatomic reduction in 26 cases （63.3%） satisfied with reduction in 10 cases （32,7%） are not satisfied with reduction in 2 cases （45%）. Excellent clinical and X-rates were 70.5% and 71.8% of which anatomy and non-anatomical reduction and excellent rate of clinical group were 83.9% and 36.4% （Χ^2= 22.89, P〈0.01）. Complication Incomplete sciatic nerve injury of drafting 1 case （1.0%）; deep infection, 2 cases （2.0%）. Conclusion The reduction is closely related to the quality and efficacy. With open reduction and internal fixation of fractures of different treatment of unstable pelvic ring fracture may be to achieve a satisfactory fracture reduction and treatment effect.