不稳定型骨盆骨折合并Morel-Lavallée损伤的手术治疗

[目的]探讨不稳定型骨盆骨折合并Morel-Lavallée损伤的手术方法及其治疗结果.[方法]2006年6月～2011年3月,共收治不稳定型骨盆骨折合并Morel-Lava11ée损伤患者20例.根据Tile的分型方法,B型骨盆损伤5例,C型15例.本组Morel-Lavallée损伤与骨盆骨折均同期手术治疗.其中骨盆骨折采取切开复位内固定;Morel-Lavallée损伤行切开清创、囊壁刮除、加压脉冲冲洗、夹层间缝合、一期闭合伤口、多通道负压引流.术中见假性滑囊形成12例,血肿机化伴不成熟假性滑囊8例.[结果]术后随访6 ～ 57个月,平均20个月,17例患者伤口一期愈合,无切口深部感染、皮肤软组织坏死、复发性假性滑囊形成等并发症.1例患者伤口脂肪液化,1例患者伤口见粘稠分泌物,细菌培养无阳性发现,1例患者伤口浅表感染,以上3例患者经对症处理,伤口均获痊愈;骨盆骨折Majeed疗效评分为68～100分,平均86分.[结论]不稳定型骨盆骨折合并的Morel-Lavallée损伤范围广泛,难免与骨盆骨折手术切口相通,在处理骨盆骨折的同时一期对Morel-Lavallée损伤行彻底切开清创、囊壁刮除、加压脉冲冲洗、夹层间缝合、一期闭合伤口、多通道负压引流,可取得满意疗效.     

不稳定型骨盆骨折的手术方式探讨

目的 探讨不稳定型骨盆骨折的手术方式及其临床疗效. 方法 回顾性分析2006年3月至2010年5月采用手术治疗且获得随访的29例不稳定型骨盆骨折患者资料,男18例,女11例;年龄24 ～61岁,平均38.4岁.骨折Tile分型:B型13例,其中B1型3例,B2型7例,B3型3例;C型16例,其中C1型8例,C2型4例,C3型4例.受伤至手术时间为6h至10 d.14例骶骨翼骨折合并前环骨折患者后环行经皮骶髂关节螺钉内固定,前环采用钢板内固定;4例骶髂关节脱位合并前环损伤患者采用髂腹股沟入路行前后环内固定;9例骨盆骨折合并移位明显的髋臼骨折患者行单一或联合入路切开复位钢板内固定;2例全身情况不稳定或合并多发伤的患者行外固定支架及微创内固定治疗. 结果 29例患者术后获平均14.5个月(7～19个月)随访.2例患者手术切口发生脂肪液化,行伤口换药后愈合.骨折复位质量根据Matta标准评定:优17例,良9例,可1例,差2例,优良率为89.7％.末次随访时Majeed评分平均为86.7分(53 ～100分),其中优18例,良7例,可2例,差2例,优良率为86.2％.2例患者发生创伤性关节炎. 结论 对于不稳定型骨盆骨折,根据患者全身情况和不同的骨折类型采用骶髂关节螺钉或钢板进行内固定可获得较满意的临床效果.对于全身情况不稳定者,外固定支架固定是一种较好的选择.     

血流动力学平衡在骨盆骨折治疗中的作用

[目的]探讨血流动力学平衡在骨盆骨折治疗中的作用.[方法]对2003年1月-2009年6月收治的48例骨盆骨折合并血流动力学不稳患者救治资料进行回顾性分析.[结果]成功救治40例,8例死亡,死亡率16.7%.38例得到随访,随访10～36个月,平均16.6个月.骨盆骨折复位按照Matta评定标准:优良率为89.5%.功能按Majeed评定标准:优良率为92.1%.[结论]骨盆骨折合并血流动力学不稳患者病情较复杂,应用伤害控制策略、多科协作、早期应用骨盆外固定维持血流动力学平衡,能减少并发症,提高救治成功率.     

手术治疗不稳定型骨盆骨折的近期疗效

目的 探讨不稳定型骨盆骨折的手术治疗方法及近期疗效. 方法 回顾性分析2004年2月至2011年2月期间收治且获得随访的113例新鲜不稳定型骨盆骨折患者资料,男75例,女38例;中位年龄为41岁(12 ～73岁).骨折按Tile分型:B型49例,其中B1型24例,B2型14例,B3型11例;C型64例,其中C1型41例,C2型12例,C3型11例.56例患者存在合并伤.所有患者均采用手术治疗,根据骨折类型不同采用单纯前环固定24例,单纯后环固定36例,前后环联合固定53例.末次随访时根据Majeed功能评分和Harris髋关节评分标准评定患者的临床疗效. 结果 113例患者术后获8～ 60个月(平均24个月)随访.末次随访时采用Majeed功能评分标准评定疗效:平均评分为88.2分(48 ～100分),其中优76例,良22例,可12例,差3例,优良率为86.7％;31例合并髋臼骨折患者优良率为77.4％(24/31),18例合并股骨骨折患者优良率为77.8％ (14/18).末次随访时采用Harris髋关节评分标准评定疗效:平均评分为89.5分(46 ～100分),其中优78例,良24例,可6例,差5例,优良率为90.3％.12例合并腰骶丛神经损伤患者中,6例遗留有不同程度足踝背伸受限. 结论 选择合适手术方法治疗不稳定型骨盆骨折可取得良好疗效.     

不稳定骨盆骨折的手术治疗

目的 总结不稳定骨盆骨折手术治疗的临床效果.方法 回顾性研究2002年1月至2008年1月手术治疗、病历资料完整、受伤至手术时间在60 d以内,并获得随访的83例不稳定骨盆骨折患者资料.按照Tile骨盆骨折分型:B型35例,其中B1型17例,B2型11例,B3型7例;C型48例,其中C1型34例,C2型9例,C3型5例.66例患者伴有合并伤.25例伴有骶骨骨折:1区5例,2区16例,3区4例.合并髋臼骨折23例.12例患者因血流动力学不稳定而行急诊抢救.所有患者根据骨折类型及伤情分别采用单纯前环固定(17例)、单纯后环固定(29例)及前后环同时固定(37例)治疗.最终随访时采用Majeed评分和Harris评分评定疗效.本组患者受伤至手术时间平均12.0 d(0～51 d).结果 1例患者在住院期间死亡,其余82例患者术后获平均3.3年(1.0～7.1年)随访.术后82例患者Majeed评分平均87.5分(51～100分),其中优54例,良22例,可4例,差2例,优良率为92.7%;Harris评分平均91.1分(50～100分),其中优59例,良17例,可1例,差5例,优良率为92.7%.合并髋臼骨折行手术治疗的17例患者,14例效果优良.19例腰骶丛神经损伤患者,11例基本恢复,5例不完全恢复,3例无恢复.医源性神经损伤10例,9例完全恢复,1例不全恢复,仍残存足踝背伸力弱.3例发生内固定失效. 结论 手术治疗不稳定骨盆骨折可获得良好疗效,合并严重腰骶丛神经损伤、固定失效及合并髋臼骨折会影响最终疗效.     

不稳定型骨盆骨折合并多发伤的损伤控制

目的探讨损伤控制骨科(damage control orthopaedics,DCO)技术在不稳定型骨盆骨折合并多发伤中的应用。方法回顾性分析应用DCO技术治疗的43例不稳定型骨盆骨折合并多发伤患者的临床资料:第一阶段用骨盆外固定支架固定不稳定型骨盆骨折,并进行其他简化手术、控制致命性大出血;第二阶段行ICU复苏治疗;第三阶段行确定性修复重建手术。结果 2例死亡,4例未随访,37例平均随访23.6月。按Matta标准评定疗效:优18例,良12例,可2例,差5例,总优良率81.1%。结论不稳定型骨盆骨折合并多发伤病情较重,采用DOC技术有利于稳定血流动力学,提高救治成功率,降低死亡率和伤残率。     

不稳定骨盆骨折的手术治疗

目的探索不稳定骨盆骨折手术内固定治疗的效果。方法20例不稳定型骨盆骨折按Tile分类确定为B、C型并行手术治疗。结果平均随访1a，结果满意。结论切开复位内固定术可有效复位固定骨折，恢复骨盆的稳定性，早期功能锻炼，减少病残率的发生。     

损伤控制技术在血流动力学不稳定型骨盆骨折中的应用分析

目的探讨损伤控制技术在血流动力学不稳定型骨盆骨折急救治疗中的应用效果。方法对本院2014年4月至2016年8月期间急诊收治的45例血流动力学不稳定型骨盆骨折患者予以基于损伤控制理念的进行抢救治疗及随访分析。结果经过基于损伤控制技术的抢救后,存活率为86.67%。存活患者随访结果显示,Majeed骨折复位恢复总优良率为82.05%(32/39)。生活质量评分平均(68.45±6.02)分。结论在血流动力学不稳定型骨盆骨折患者急诊救治过程中运用损伤控制技术有助于控制出血,减少多器官功能衰竭等并发症的发生,提高抢救成功率。     

骨盆骨折合并阴道损伤的早期诊断和治疗

 目的 探讨骨盆骨折合并阴道损伤的早期诊断和治疗策略。方法 回顾性分析2000年1月至2010年7月收治的13例骨盆骨折合并阴道损伤患者的病历资料,年龄17～52岁,平均31.7岁。按Tile骨盆骨折分类系统分类：B1型4例、B2型1例(Tilt骨折)、B3型4例、C1型3例、C2型1例。3例急诊行阴道损伤修复、骨盆骨折切开复位内固定术;5例血流动力学不稳定者,积极抗休克治疗,病情稳定后急诊行阴道修复、骨盆骨折外固定支架固定术;2例延迟诊断阴道损伤,确诊后及时行阴道修复术,1例行骨盆骨折切开复位内固定术,另1例行外固定支架固定术;2例因外院漏诊阴道损伤,形成盆腔脓肿,行彻底清创、骨盆骨折外固定支架固定术,待感染控制后二期行阴道重建术。结果 12例存活,1例入院后6 h死亡。11例获得随访,平均随访17个月(8~36个月)。阴道损伤一期修复的9例患者中已婚者6例,5例性生活正常,1例存在性交时疼痛;未婚者3例,月经正常。阴道损伤二期重建的2例患者,均存在性交时疼痛。末次随访时Majeed骨盆骨折术后功能评分平均82.2分(56～96分),优6例、良3例、可2例。结论 女性骨盆骨折存在骨盆前环损伤,应高度怀疑阴道损伤的可能。早期诊断并修复阴道损伤是处理的关键,可获得较好的临床效果;延误诊断和治疗可导致严重的并发症,临床效果差。     

腹部脏器损伤合并骨盆骨折和休克患者的损伤控制治疗

目的探讨一体化损伤控制救治模式对腹部脏器损伤合并休克患者的救治效果。方法回顾性分析2009年6月至2014年9月本院收治的血流动力学不稳定型骨盆骨折合并腹部脏器损伤患者32例,所有病例损伤严重度评分(ISS)平均36.1分(35.2±2.94),采用院前院内一体化损伤控制救治模式进行治疗。腹部损伤应用填塞止血、简单修补、结肠造瘘等方法处理,病情稳定后再二期行骨折确定性内固定、腹部脏器确定性修复重建手术。统计分析患者抢救成功率、死亡率、并发症发生率、临床疗效等指标。结果 32例患者中死亡5例(15.62%),抢救成功率84.38%,发生严重并发症6例(18.75%)。24例行二期内固定手术,术后恢复良好,有2例发生伤口愈合不良;患者行腹部脏器损伤二期重建手术均顺利度过围手术期,未发生严重术后并发症。结论严重骨盆骨折合并腹部脏器损伤病情危急、处理复杂,应用院前院内一体化损伤控制救治模式进行多科协作救治,能有效提高救治成功率。     

Functional outcome of internal fixation for pelvic ring fractures.

OBJECTIVE: Evaluation of the functional outcome after unstable pelvic ring fractures stabilized with internal fixation. METHODS: Between January 1, 1990, and September 1, 1997, 37 patients were treated with internal fixation for unstable pelvic fracture. Demographic data, type of accident, Hospital Trauma Index-Injury Severity Score, and fracture type according to Tile classification were scored. One patient died the day after the accident from neurologic injury. A Short Form-36 health questionnaire and a form regarding functional result after pelvic trauma, adapted from Majeed et al., were returned by 31 of 36 patients (86%). Twenty-eight patients (78%) were seen for physical and radiologic examination. RESULTS: Twenty-six men and 11 women, with an average age of 34.7 years (range, 15-66 years) were included. The mean Injury Severity Score reached 30.4 (range, 16-66). According to the Tile classification, there were 16 type B fractures and 21 type C fractures. Seven patients were treated with open reduction and internal fixation of the pubic arch, 10 patients were treated with a combination of anterior open reduction and internal fixation with additional external fixation to increase the stability of the posterior ring. Nineteen patients underwent internal fixation of both anterior and posterior arch. In the remaining case, percutaneous posterior screw fixation was combined with anterior external fixation, because of estimated infectious risk. The average follow-up time was 35.6 months. Patients scored 78.6 of 100 on the Majeed score. Remarkable was the reported change in sexual intercourse in 12 patients (40%). Only 12 patients (40%) did not have complaints when sitting. On the SF-36 scales physical and social functioning, role limitations due to physical problems and vitality were limited compared with the averages for the Dutch population. Patients treated with combined anterior and posterior internal fixation scored significantly better on both the Majeed score and on the categories physical functioning, pain, general health and social functioning compared with patients with similar fractures treated with a combination of anterior internal fixation with external fixation. At the physical examination, 11 of 28 patients (39%) did not have any abnormality. Nineteen patients (68%) were back at their original job, which was physically demanding in 9 cases. There was a suspicion of nonunion of the posterior arch in two patients, which could be confirmed with a computed tomographic scan. CONCLUSION: In general, limitations in functioning are reported, even after long-term follow-up. In partially unstable fractures, solitary anterior fixation gives good results. In completely unstable fractures, patients treated with combined internal fixation anterior as well as posterior scored a better outcome compared with combined internal and external fixation. Therefore, this technique is recommended as treatment of first choice in completely unstable fractures.     

闭合复位内固定联合外固定架治疗不稳定骨盆骨折

目的:探讨经皮螺钉内固定联合外固定架治疗不稳定骨盆骨折的临床效果。方法:自2006年4月至2009年5月,采用闭合复位内固定联合外固定架治疗29例旋转不稳定型骨盆骨折患者,男19例,女10例;年龄19～53岁,平均31岁。按照Tile分型:C1型17例,C2型12例。术后采用Tornetta标准和Majeed功能评分进行疗效评价。结果:29例患者均获随访,时间10～24个月,平均16个月。术后无神经损伤及盆腔脏器损伤等并发症发生,伤口愈合好,仅1例出现钉道口感染,换药后治愈。骨折均获骨性愈合,愈合时间为14～18周,平均16.2周。未见螺钉松动、脱出、断裂。按照Tornetta评价,优 14例,良10例,可 4例,差 1 例。末次随访Majeed评分为87.2±11.3,优16例,良9例,可4例。结论:对于不稳定C1、C2型骨盆骨折,采用闭合复位内固定联合外固定架可以取得满意的治疗效果。     

Similar patient reported outcomes at long-term follow-up after external fixation versus internal fixation of the anterior ring component of APC injuries

Purpose: Unstable pelvic ring injuries produced by external rotation of the hemipelvis and a symphyseal disruption are most often treated with internal fixation of the anterior ring, with percutaneous treatment of the posterior ring as needed. In some clinical situations, patients are treated with external fixation for their anterior injuries and the long-term functional outcomes associated with external fixation are not well understood. We ask if there is a difference in functional outcome, between treatment of these injuries with internal versus external fixation, when measured at a minimum of three years after injury.Method: This was a retrospective cohort study performed at a level one regional trauma center. Trauma database review identified 128 patients, with 70 subsequently excluded, with unstable anterior posterior compression (APC) pelvic ring injuries (OTA 61B2.3 & 61C1.2) treated with surgery with minimum three years of follow-up. An intervention of internal fixation versus external fixation of anterior pelvic ring was performed, and depending on the injury, supplemented with posterior iliosacral screw fixation. Main outcome was measured with the Majeed functional outcome score (0-100).Results: Patients treated with external fixation reported a Majeed score of 70 (95% CI 28-100) compared to 79 (95% CI 36-100) in those with internal fixation (p-value 0.28). Subgroups of the Majeed score were not significantly different (p value > 0.05). Open fractures, severity of injury, and ISS were worse in those treated with external fixation. There was no differential loss to follow-up.Conclusion Patients with unstable pelvic ring injuries with symphyseal disruptions treated with external fixation as definitive treatment versus internal fixation may fare no different in the long term.     

外固定支架结合锁定加压钢板在不稳定骨盆骨折治疗中的应用

目的 探讨外固定支架结合锁定加压钢板技术在不稳定骨盆骨折治疗中的应用及效果.方法 对2007年6月至2008年7月获得随访的12例不稳定骨盆骨折患者进行回顾性分析,男9例,女3例;年龄22～51岁,平均36.2岁.均采用髋臼上方外固定架固定前环骨折,锁定加压钢板固定后环骨折的技术.按照Tile分型:B1型5例,B2型3例,B3型2例;C1型2例.合并直肠或膀胱损伤3例,血气胸、颅脑损伤3例,腰骶神经损伤2例,多发骨折8例. 结果 12例患者术后获3～12个月(平均6.3个月)随访.手术时间40～120 min(平均70 min).支架保留时间6～16周(平均11周).骨盆骨折或脱位的愈合时间为12～19周(平均14周).骨折复位按照Tornetta评估标准:优7例,良4例,可1例.术后功能评定按Majeed评分标准:优6例,良4例,可2例.并发症包括2例早期负重行走时后方疼痛,经卧床休息延迟负重后缓解;6例有不同程度钉道感染,2例腰骶神经损伤患者3个月后神经功能部分恢复,无严重医源性并发症和合并症发生. 结论髋臼上方置钉外同定支架技术可有效恢复骨盆前方稳定性,通过股骨牵引还可以达到对骶髂关节的加压.跨骶骨髂骨间锁定加压钢板对骨盆后方的固定有一定优势.两种技术结合应用,创伤较小、手术操作简单,能达到不稳定骨盆骨折微创治疗的目的 .     

Clinical outcomes of unstable pelvic fractures in skeletally immature patients

BACKGROUND: The orthopaedic literature contains few studies evaluating the long-term outcomes of unstable pelvic fractures in skeletally immature patients. The purpose of this study was to determine the factors that may influence the clinical and functional outcomes of such fractures. METHODS: A retrospective review of all patients with open triradiate cartilages and an unstable pelvic (Tile type-B or C) fracture treated, from 1986 to 2000, at one of two level-I trauma centers was performed. Patients were evaluated with a review of their medical records, the Modified Injury Severity Score (MISS), standardized physical examination, standardized radiographic evaluation, and the Short Musculoskeletal Function Assessment Questionnaire (SMFA). The outcomes were then used to assess the difference between patients who had been treated operatively and those who had been treated nonoperatively. RESULTS: Of 230 pelvic fractures treated during the study period, twenty-three in twenty-three patients were unstable. Of the twenty-three patients, twenty, with a mean age of 9.5 years at the time of injury, were evaluated. The mean duration of follow-up was 6.5 years. There were four type-B and sixteen type-C fractures according to the Tile classification system. The four patients with a type-B fracture had a mean of 1.4 cm of pelvic asymmetry at the time of union and the last follow-up, whereas the sixteen patients with a type-C fracture had a mean of 1.5 cm of pelvic asymmetry at those times. Pelvic asymmetry did not remodel even in younger patients. Eighteen patients were treated operatively with external fixation, internal fixation, or a combination of both, and pelvic asymmetry of < or =1 cm was achieved in ten of them. Patients who had < or =1 cm of pelvic asymmetry had no lumbar or sacroiliac pain, no or mild sacroiliac tenderness, no Trendelenburg sign, no lumbar scoliosis, and lower (better) bother and dysfunction scores on the SMFA compared with patients with more pelvic asymmetry. All patients with > or =1.1 cm of pelvic asymmetry had three or more of the following: nonstructural scoliosis, lumbar pain, a Trendelenburg sign, or sacroiliac joint tenderness and pain. Patients with fewer associated injuries and pelvic asymmetry of < or =1 cm had better clinical results. CONCLUSIONS: Unstable pelvic fractures in children can result in long-term morbidity and functional problems. Fractures associated with > or =1.1 cm of pelvic asymmetry following closed reduction should be treated with open reduction and internal or external fixation in order to improve alignment and the long-term functional outcome.     

骶髂螺钉固定治疗垂直不稳定骨盆后环骨折的疗效分析

目的评价骶髂螺钉治疗不稳定型骨盆骨折的临床疗效。方法采用骶髂螺钉治疗42例不稳定型骨盆骨折。应用Tornetta复位情况评价表评估复位情况,应用Majeed骨盆骨折评分系统评价疗效。结果 42例均获随访,随访时间为4~34个月,平均15个月。闭合复位骶骨钉内固定骨盆骨折后环不稳术后分疗效满意。结论掌握骶骨置钉技巧,应用骶骨钉固定骨盆骨折后环不稳,手术操作简单、疗效好、适于基层医院广泛开展。     

骨盆环不稳定性骨盆骨折的手术入路和内固定选择

目的 :探讨在骨盆环不稳定骨盆骨折中手术入路与内固定的选择。方法 :2010年5月至2015年5月,45例骨盆前后环不稳定患者分别采取不同的固定方法及手术入路治疗,男38例,女7例;年龄21~61岁,平均45岁;病程在2周内。按照Young-Burg分型,其中LC型23例,VS型6例,APC型16例。术前患者髋部疼痛,活动受限,摄片示骨盆环断裂骨折移位。结果:术后患者伤口愈合佳,无相关并发症。45例患者术后获得随访,时间9~21个月,平均13个月。术后患者髋部疼痛缓解,X线片示骨盆复位满意,骨盆环形态恢复良好。Majeed功能评分(93.5±11.6)分;结果优35例,良8例,可2例。结论:伴有骨盆环不稳定的骨盆髋臼骨折,往往并发复合伤,手术原则既要考虑减少手术创伤,又要顾及骨折复位,特别要考虑关节内骨折复位和骨盆环的稳定性,所以往往需要切开手术入路和微创手术相结合,才能达到满意的疗效。     

移位髋臼骨折合并不稳定型骨盆后环损伤的临床特征及复位顺序

目的 探讨移位髋臼骨折(displaced acetabular fracture,DAF)合并不稳定型骨盆后环损伤(posterior pelvic injury,PPI)的临床特征及复位顺序.方法 1997年3月至2007年3月,资料完整的DAF合并PPI患者39例,合并同侧PPI 25例、对侧9例、双侧5例.根据AO/OTA分型方法,髋臼A型骨折9例,B型25例,C型5例;骨盆后环B型损伤31例,C型8例.DAF与PPI同期切开复位内固定33例,分期手术3例,另3例PPI行非手术治疗.术中首先复位DAF 10例,首先复位PPI 18例,DAF与PPI同时复位11例.结果 术后随访12～120个月,平均33.7个月.根据Matta的评价标准,DAF解剖复位27例、复位满意4例、不满意8例.根据Meats的评价标准,PPI解剖复位24例、复位满意8例、不满意7例.其中因PPI移位而影响DAF满意复位者7例.DAF术后Matta功能评分为4～18分,平均14.7分.PPI术后Majeed疗效评分为51～100分,平均87.8分.以两个损伤部位的最低评分作为总体治疗结果,优25例、良3例、可2例、差9例.结论 在处理累及髋臼双柱的DAF合并PPI时,PPI的准确复位是DAF获得满意复位的解剖基础,DAF的损伤类型及其复位质量是决定远期疗效的主要因素.     

前环皮下内置外固定架联合后环骶髂螺钉治疗不稳定骨盆骨折

目的评估应用前环皮下内置外固定架(internal fixation,INFIX)联合后环骶髂螺钉治疗不稳定骨盆骨折的临床疗效。方法2016年8月-2017年9月,采用前环皮下INFIX联合后环骶髂螺钉治疗不稳定骨盆骨折19例。其中男14例,女5例;年龄17~69岁,平均40.6岁。致伤原因:交通事故伤11例,高处坠落伤5例,重物砸伤3例。骨折根据Tile分型,B1型2例,B2型6例,C型11例。前环损伤包括双侧耻骨坐骨支骨折12例,单侧耻骨坐骨支骨折5例,耻骨联合分离2例;后环损伤包括骶髂韧带损伤2例,单侧髂骨骨折3例,单侧骶骨骨折11例,单侧骶髂关节脱位2例,双侧骶骨骨折1例。受伤至手术时间2~11 d,平均6.1 d。记录术中出血量及手术时间,观察骨折愈合情况及术后并发症情况。采用Matta评分标准评价骨折复位情况,采用Majeed评分标准评估患者术后功能。结果患者手术时间为47~123 min,平均61.4 min;术中出血量为50~115 mL,平均61.1 mL。术后1例发生植钉处切口浅表感染,1例发生单侧股外侧皮神经激惹,经相应处理后治愈或症状消失。无泌尿系统、生殖系统及肠道等损伤。所有患者均获随访,随访时间12~25个月,平均18.1个月。术后骨折均愈合,愈合时间8~13周,平均9.5周;无骨折不愈合、延迟愈合,内固定物松动、断裂等情况发生。2例术前腰骶丛神经损伤患者中,1例功能完全恢复,1例残留轻度跛行症状。末次随访时采用Matta评分标准评价骨折复位情况,获优13例、良6例,优良率100%;采用Majeed评分标准评价功能,获优15例、良4例,优良率100%。结论应用前环皮下INFIX联合后环骶髂螺钉治疗不稳定骨盆骨折临床疗效满意,并发症较少,是一种微创治疗骨盆环损伤的有效方法。