拉力螺钉固定技术在骨盆后环损伤中的临床应用

【目的】探讨应用拉力螺钉固定技术治疗骨盆后环损伤的适应证、手术方法及疗效。【方法】对在我院治疗的58例骨盆骶髂复合结构损伤患者分别采用后侧经骶髂关节或（和）跨骶骨的拉力螺钉固定方法治疗骨盆后环损伤。所有操作均在“C”型臂X线机透视下进行。【结果】56例患者获得随访，随访时间6年6个月，平均23．5个月。平均手术时间为70min。58例共置入拉力螺钉128枚。患者在术后2—4个月双下肢可完全负重行走，并逐渐恢复体力劳动。仅发生3枚螺钉松动、未发生神经损伤及螺钉断裂等并发症，腰骶及下肢活动接近正常。【结论】拉力螺钉固定技术可使不稳定性骨盆后环损伤患者获得良好的即刻复位和固定，恢复骨盆环的稳定性，适用于骶髂关节脱位及骶骨骨折患者。

The clinical exploration of the lag sarews fixation for the injuries in the posterior ring of pelvis

Objective] To explore the indication, operative procedure and effect of lag screws fixation in the injuries of posterior ring of pelvic. Methods] 58 patients with injuries in the posterior ring of pelvis were treated with lag screw fixation. The whole procedure was performed under the monitoring of the ＂C-arm＂ x - roy for safety and accuracy. Results] 56 patients were avail- able for follow - up with a mean of 23.5 months （range from 6 months to 6 years ） . The operations lasted 70 minutes averagely. A total of 128 screws were fixed in 58 patients. The patients could walk with full weight - bearing at the 2 - 4 month after operation. The function of the sacroiliac joint and low extremities recovered nearly to normal. There were no nerve injuries and breakage but with loosening of only 3 screws. Condusions] The technique of lag screw fixation is able to reduce and fix the unstable injuries in the posterior ring of pelvis perfectly and immediately after operation. It not only can rebuild the stabihty of pelvis, but also can be applied to the fractures.