骨盆前、后环不稳定的治疗策略

目的探讨骨盆前后环不稳定的治疗策略。方法对22例Tile C型骨盆前、后环不稳定患者均急诊采用股骨髁上骨牵引结合外固定架固定,病情平稳后行前、后路重建钢板联合骶髂螺钉复位内固定术治疗。结果22例均获随访,时间6~31个月。疗效根据Matta评分标准评定:优21例,良1例。根据Majeed功能评分评定:优18例,良2例,差2例。结论先早期外固定架临时固定,二期行手术内固定,手术安全、固定可靠,可早期功能锻炼及负重,是治疗骨盆前后环不稳定的有效方法。

The treatment strategy of the unstable anterior and posterior pelvic ring

Objective To evaluate the treatment strategy of the unstable anterior and posterior pelvic ring. Methods 22 patients with the unstable anterior and posterior pelvic ring （type C Tile fracture）were treated by the use of exter-nal fixator arid the skeletal traction through supracondyle of femur in emergency operation. After the disease stabiliza-tion, surgical treatment was performed for unstable pelvic fracture by pelvic reconstructive plates arid iliosacral screw fixation . Results 22 patients were followed up for 6 ～ 31 months. According to Matta criterion for fracture reduc-fion,the results were excellent in 21 cases arid good in 1. According to Majeed functional scoring,the results were ex-cellent in 18 cases,good in 2 and poor in 2. Conclusions The unstable anterior and posterior pelvic ring （type C Tile fracture） can be treated by the use of external fixator in the emergent treatment, with open reduction and internal fixation in late stage. The treatment strategy is a safe, effective, reliable fixation and less invasive method, and early functional exercise and early loading can be trained.