INFIX治疗不稳定性骨盆前环损伤的临床疗效及早期并发症分析

目的对比分析微创经皮骨盆前环内固定术(minimal invasive subcutaneous internal fixator,INFIX)治疗不稳定性骨盆前环损伤的临床疗效及早期并发症发生情况。方法选取2015年4月至2019年4月东莞市企石医院收治的48例不稳定性骨盆前环损伤患者作为研究对象,并按照随机数表法将其随机分为观察组(24例)和对照组(24例),其中观察组患者采用INFIX治疗,对照组患者采用钢板内固定术治疗,对比两组患者手术时间、术中出血量、术后6个月骨折复位效果、术后6个月功能恢复情况以及早期切口感染、血管损伤、股神经损伤、股外侧皮神经损伤等并发症发生情况。结果观察组患者手术时间明显短于对照组(t=4.638,P=0.000),术中出血量明显少于对照组(t=4.239,P=0.000),术后6个月骨折复位效果及功能恢复情况与对照组无明显差异(Z=-0.606、-0.141,P=0.545、0.888);随访6个月,观察组患者神经损伤发生率明显高于对照组(χ~2=4.364,P=0.037),切口感染及血管损伤发生率与对照组无明显差异(χ~2均=2.087,P均=0.149)。结论INFIX治疗不稳定性骨盆前环损伤能够达到与钢板内固定同等的固定及复位效果,且操作更简便,对骨折部位血运破坏更小,但应熟练掌握解剖结构、手术操作技巧以减少股外侧皮神经及股神经损伤。

Analysis of Clinical Efficacy of INFIX in the Treatment of Unstable Anterior Pelvic Ring Injury and Early Complications after the Treatment

Objective To compare and analyze the clinical efficacy of minimal invasive subcutaneous internal fixator(INFIX) in the treatment of unstable anterior pelvic ring injury and early complications after the treatment.Methods Forty-eight patients with unstable anterior pelvic ring injury,admitted to Dongguan Qishi Hospital from April 2015 to April2019 were selected as the research subjects and then were divided,according to random number table,into an observation group(24 cases) and a control group(24 cases).Patients in the observation group were treated with INFIX while patients in the control group were treated with steel plate internal fixation.The surgery time,blood loss during surgery,fracture reduction effect 6 months after surgery,and functional recovery 6 months after surgery and complications,such as infection of incisional wounds at early stage,vascular injury,femoral nerve injury and lateral femoral cutaneous nerve injury were compared between the two groups.Results The surgery time for patients in the observation group was significantly shorter than the control group(t=4.638,P=0.000),the blood loss during surgery in the observation group was significantly less than the control group(t=4.239,P=0.000) and no significant difference was observed in fracture reduction effect and functional recovery 6 months after surgery betwwen the observation group and the control group(Z=-0.606,-0.141,P=0.545,0.888);during 6-month follow-up,the incidence of nerve injury was significantly higher in the observation group than the control group(χ~2=4.364,P=0.037) and no significant difference was observed in the incidence of infection of incisional wounds and vascular injury between the observation group and the control group(allχ~2=2.087,all P=0.149).Conclusion Treatment of unstable anterior pelvic ring injury with INFIX can achieve the same fixation and reduction effect as steel plate internal fixation.INFIX is easier in operation and causes less damage to blood circulation in the fracture site.However,it is necessary for doctors to have a good knowlege of anatomical structure and master operative techniques to reduce the injuries of lateral femoral cutaneous nerve and femoral nerve.