使用TOS装置固定术治疗垂直不稳定型骨盆骨折

目的探讨应用脊柱钉棒系统类似三角形的骨折固定技术（triangufar ostee synthesis,TOS）治疗垂直不稳定型骨盆骨折的临床效果。方法对2008年5月至2010年12月收治的11例垂直不稳定型骨盆骨折患者进行手术治疗,采用后路腰骶部正中切口入路,安装L（4～5）椎弓根及髂后上棘椎弓根螺钉,将垂直、旋转移位复位固定。11例病人均属于Tile C型骨折,男7例,女4例。年龄20～48岁,平均34岁。结果 11例患者术后10例获得6～20个月随访,平均12.7个月。术后X线片均示骨盆骨折复位满意。根据Matta骨盆骨折复位评定标准,优7例,良3例。术前有4例骶丛神经损伤,术后3例神经症状恢复,1例解。未出现医源性神经、血管损伤。下肢行走、蹲屈功能恢复满意。有1例伤口感染,延迟愈合。结论使用脊柱钉棒系统TOS装置固定术治疗垂直不稳定型骨盆骨折具有疗效满意,器械操作相对简单熟悉部分缓,并发症少等优点。

Use TOS Fixation Device to Treat Vertically Unstable Pelvic Fractures

Objective To study the application of triangular Osteosynthesisto to treat vertically unstable pelvic fractures. Methods From May 2008 to December 2010,11 cases of vertically unstable pelvic fractures were treated with surgery trough the posterior midline incision. Pedicle screws in L4-5 and posterior superior iliac spine were im panted. The vertical and rotating dislocation was reducted. 11 case were Tile C fracture. There are 7 males and 4 fc-males. Results 10 of the 11 patients were followed up for 6-20 months. Postoperative X ray showed that and thcpelvic fractures were reducted. According to Matta pelvic fractures reduction evaluation standard,ther were excellcnt in 7 cases ,good in 3 cases. Preoperative there were 4 cases of di plexus nerve lesion, 3 cases of them recovered post-operation operation. There were no nerve or vessel lesion. Function recovery was satisfactory. And there was one case of infcc-tion and delayed healing. Conclusion The use of the TOS with pedical screws to treat vertically unstable pelvic frac-tures has good clinical effect.