骨盆的形态特点与不稳定型骨折内固定治疗评价

目的　探讨根据骨盆的形态特点选择不同的内固定手术治疗不稳定型骨盆骨折的临床应用价值。 方法　65例不稳定型骨盆骨折，31例Tile B型骨折经前入路，将耻骨联合或耻骨支复位用重建钢板固定，其中8例合并髂骨骨折经髂窝入路将之复位用重建钢板固定；34例Tile C型骨折的前环损伤均采用与Tile B型骨盆骨折相同的方法处理，后环损伤的固定方法：17例骶骨骨折或骶髂关节脱位之中，复位后在透视引导下从后方经皮骶髂螺钉固定11例，经髂骨的螺栓固定4例，经后路在双侧髂骨后嵴之间用张力带钢板固定2例；9例骶髂关节骨折-脱位之中，经皮骶髂螺钉固定6例，钢板固定3例；8例合并髋臼骨折行重建钢板内固定。 结果　通过对术后骨盆X线测量骨折分离移位的最大距离，根据Matta评分标准：小于4 mm为优，占86.1%（56例）；4~10 mm为良，占7.7%（5例）；10~20 mm为可，占6.2%（4例）；大于20 mm为差（0例）。本组骨盆X线测量结果总优良率为93.8%。 结论 不稳定型骨盆骨折应在血流动力学稳定时尽早根据骨折的类型及骨盆的解剖形态特点选择合理的内固定手术方案。

Internal fixation of the unstable pelvic fracture based on the anatomic features of the pelvis

Objective To explore clinical efficiency of different surgical internal fixations on treating the unstable pelvic fracture according to the anatomic features of the pelvis.Methods 65 cases suffering from the unstable pelvic fractures,were included in this study.Anterior approach,with the replacement and plate fixation of symphysis pubis or ramus of pubis,was performed for 31 cases of Tile B type fracture.8 cases combined with ilium fracture among them were replaced and fixed through iliac fossa approach.As ...