经皮骶髂螺钉和骶髂关节前路钢板内固定治疗不稳定骨盆骨折的临床疗效比较

目的探讨经皮骶髂螺钉和骶髂关节前路钢板内固定治疗不稳定骨盆骨折的临床疗效。方法选取2012年1月~2014年1月收治的149例不稳定骨盆骨折患者,根据治疗方法将其分成骶髂钢板组和骶髂螺钉组。其中骶髂钢板组74例,给予骶髂关节前路钢板内固定治疗;骶髂螺钉组75例,给予经皮骶髂螺钉治疗。比较两组患者临床资料、手术相关指标、临床疗效以及术后并发症。结果两组患者性别、年龄、致伤原因、合并伤以及Tile分类等资料数据比较差异无统计学意义(P0.05);骶髂螺钉组患者手术时间、出血量、切口长度以及住院时间[(86.1±11.2)min,(16.7±8.5)m L,(1.7±0.6)cm和(8.7±2.7)d]均显著低于骶髂钢板组患者[(122.3±20.5)min,(516.3±118.7)m L,(15.7±1.5)cm和(17.7±4.8)d,P0.05];骶髂螺钉组患者骨折复位优良率和功能恢复优良率(97.3%和96.0%)均显著高于骶髂钢板组患者(79.7%和73.0%,P0.05);骶髂螺钉组患者术后并发症发生率(4.0%)显著低于骶髂钢板组患者(24.3%,P0.05)。结论经皮骶髂螺钉治疗不稳定骨盆骨折临床疗效显著,且具有出血量小、创伤小、恢复快、术后并发症少等优点,值得临床推广应用。

Clinical curative effect comparison on percutaneous sacroiliac screws internal fixation and sacroiliac joint anterior plate fixation in the treatment of unstable pelvic fractures

Objective To investigate clinical efficacy of percutaneous sacroiliac screws internal fixation and sacroiliac joint anterior plate fixation in the treatment of unstable pelvic fractures.Methods From Jan.2012 to Jan.2014,149 cases of unstable pelvic fracture were selected to study.According to the treatment method,all the patients were divided into sacroiliac plate group and sacroiliac screw group.There were 74 patients in the sacroiliac plate group treated with the sacroiliac joint anterior plate internal fixation and 75 patients in the sacroiliac screw group treated with percutaneous sacroiliac screw fixation.The clinical data,surgery-related indicators,clinical effi-cacy and postoperative complications were compared between the two groups.Results The differences of the data about gender,age,cause of injury,associated injuries and Tile classification between the two groups were not statisti-cally significant(P>0.05);the operation time,blood loss,incision length,and length of hospital stay of the patients in the sacroiliac screw group[(86.1 ±11.2)min,(16.7 ±8.5)mL,(1.7 ±0.6)cm and (8.7 ±2.7)d,respective-ly] were significantly lower than those of the sacroiliac plate group [ ( 122.3 ±20.5 ) min, ( 516.3 ±118.7 ) mL, (15.7 ±1.5)cm and (17.7 ±4.8)d,respectively(P<0.05)];the excellent and good reduction rate and good functional recovery rate of the sacroiliac screw group ( 97.3% and 96.0%) were significantly higher than those of the sacroiliac plate group (79.7%and 73.0%,P<0.05);the rate of postoperative complications of the sacroiliac screw group (4.0%) was significantly lower than that of the sacroiliac plate group (24.3%,P<0.05).Conclu-sion Percutaneous sacroiliac screw fixation for unstable pelvic fractures can achieve significant clinical effect, and lower advantages of less bleeding,less trauma,quicker recovery,and lower postoperative complication.It is worthy of wide application in clinical practice.