Tile C型骨盆骨折的后路手术治疗

目的：探讨经后入路手术内固定治疗TileC型骨盆骨折的疗效。方法：2005年1月至2009年6月采用单纯后侧入路治疗12例TileC型骨盆骨折患者,其中男8例,女4例;年龄25～58岁,平均39.5岁。伤后至手术时间7～10d,平均9.5d。入院后均行X线及CT三维立体成像检查,按照Tile分型标准：C1型5例,C2型2例,C1＋C2型4例,C3型1例。经抗休克处理,全身情况稳定后,重建钢板固定后环,前环不予内固定。术后常规患侧下肢行3～4kg皮肤牵引3周。结果：所有患者均获得随访,随访时间6～24个月,平均12.6个月,伤口愈合良好,骨折均愈合,无骨盆畸形愈合、腰骶部疼痛、下肢不等长等并发症。按照Majeed的疗效评定标准：总分（91.50±6.95）分;优10例,良2例。结论：采用单纯后侧入路固定后环治疗TileC型骨盆骨折,可矫正畸形,重建骨盆环的稳定性,效果满意。

Surgical treatment for Tile C type pelvis fracture through posterior approach

Objective: To study the clinical results of surgical treatment for Tile C type pelvis fractures with internal fixation by posterior approach. Methods: From January 2005 to June 2009,12 patients with Tile C type pelvis fracture were treated by open reduction through posterior approach. There were 8 males and 4 females,with an average age of 39.5 years ranging from 25 to 58 years. The time from injury to operation was ranged from 7 to 10 days with an average of 9.5 days. All the patients were given X-ray,3-D CT examinations before operation. The fracture were classified by Tile classification:Type C1 in 5 cases,Type C2 in 2 cases,Type C1 and Type C2 in 4 cases,Type C3 in 1 case. All the posterior rings were fixed by re-establishing steel board without anterior ring fixation after stabilization of body condition. All the patients were treated with skin traction for 3 weeks after operation. Results: All 12 patients were followed up for 6 months to 24 months with an average of 12.6 months. All the incisions healed well,and the fractures got union. No pelvic malunion,low back pain or leg length discrepancy was found. According to Majeed criteria for the evaluation of therapeutic effect,10 patients were excellent,and 2 were good. Conclusion: In the management of the Tile C type pelvis fractures,a stable pelvis can be reconstructed by fixing posterior ring simply through the posterior approach,so that further sequelae can be reduced.