旋转和垂直不稳定型骨盆骨折的手术治疗

目的 探讨旋转和垂直不稳定型骨盆骨折的临床特点及其治疗方法选择。方法 17例存在旋转和垂直不稳定的骨盆骨折患者,全部行手术治疗:骨盆前环均行切开复位内固定,骨盆后环11例采用行切开复位双钢板固定,6例在CT引导下经皮置入松质骨螺钉固定骶髂关节。结果 17例全部恢复行走功能,11例行前路切开骶髂关节双钢板固定患者中骨盆外形恢复好,但1例沿髂嵴切口有不适,6例CT引导下经皮置入骶髂关节螺钉患者骨盆外形接近完全恢复,功能恢复快而满意。结论 骶髂关节骨折脱位患者非手术治疗效果差,宜首选内固定手术治疗;而CT引导下经皮置入骶髂关节螺钉手术操作简单、时间短、出血少、损伤少、固定牢靠,是固定骶髂关节的好方法。

Surgical Treatment of Rotatally and Vertically Unstable Pelvic Fracture

Objective To delineate treatment choice of rotatally and vertically unstable pelvic fracture. Methods Seventeen cases of ro-tatally and vertically unstable pelvic fracture were retrospectively reviewed. All cases were performed with surgical treatment. Anterior ring of pelvis were treated by ORIF. About posterior ring fixation, 11 cases were treated by open reduction and double plate fixaton, 6 cases were treated by close reduction and CT - assisted lag secrew fixation. Results Seventeen patients were followed up for 3 months to 2 years. 11 patients who were treated by open reduction and double plate fixaton and 6 patients who were treated by CT - assisted reduction and lag secrew fixation were completely recovered. The appearance of pelvis and function of lower limbs had good results. Conclusion The patients with rotatally and vertically unstable pelvic fracture should be treated by surgical treatment. CT- assisted reduction and percutaneous cannulated lag secrew fixation has a good prospect in the treatment of posterior ring injury of pelvis, the operation is simple, minimal invasived and effective.