经皮骶1、2螺钉固定治疗 Tile C1.3型骨盆骨折

目的探讨经皮微创治疗Tile C1.3不稳定型骨盆骨折的应用及疗效。方法回顾性分析我院2005年3月～2011年7月收治的24例Tile C1.3型骨盆骨折临床资料,其中男性11例,女性13例;年龄17～68岁,平均33.3岁。伤后至入院时间为2～72h,平均30h;均采用术前大重量牵引复位,部分残留旋转移位者术中斯氏针或外固定架辅助复位,C型臂X线机透视引导下经皮微创S1、2椎体植入2枚空心螺钉固定骶髂关节治疗TileC1.3不稳定型骨盆骨折。结果 24例中23例获得随访,随访时间3～77个月,平均27.1个月。术后无感染及内固定失败发生,无神经及盆腔血管损伤等并发症发生。3例出现患肢短缩,短缩<2.0cm;根据Majeed评分标准,术后骨盆功能评分:优20例,良3例,优良率为100%。结论 C型臂X线机透视引导下行Tile C1.3型骨盆骨折微创内固定术,可有效重建骨盆环的稳定性,缩短手术时间,减少手术对患者的损伤及围手术期并发症的发生。

Minimal invasive treatment of Tile C1.3 pelvic fractures by implanting sacrum screws in vertebral S1,2

Objective To explore the treatment of unstable pelvic fracture （ Tile C1.3） by percutaneously minimal invasive technique. Methods From Apr. 2003 to Jul. 2011,24 patients with Tile CI： 3 pelvic fractures were treated with percutaneous screw fixation after closed reduction. There were 11 males and 13 females, aged 18- 68 years （ average 33.3 years）. Fractures were caused by traffic accident in 16 cases and failing from height in 8 cases. The interval from injury to hospitalization was from 2 to 72 hours （ mean 30 hours）. After 5-7 days of skele- tal traction,the operation was performed. Results Totally 23 patients were followed up for 3 to 77 months with an average of 27.1 months. No infection and implant failure occurred. Less than 2cm of limb shortening was found in three patients without any functional disability. According to Majeed functional scoring system,the results were excellent in 20 cases and good in 3 cases,with an excellent and good rate of 100%. Conclusion The minimal invasive fixation under the Carm fluoroscopy can restore the stability of the pelvic ring, reduce the operation time, improve clinical results and reduce perioperative complications.