经皮空心骶髂螺钉LX内固定技术的临床应用

目的：探讨经皮空心骶髂拉力螺钉LX内固定技术的临床应用。方法：采用体表定位结合螺旋CT和C形臂引导，经皮空心骶髂拉力螺钉LX内固定技术治疗31例无重要神经血管损伤的B型骨盆创伤及5例骶髂关节炎．2例骶骨囊性病变。男27例，女11例；年龄18-59岁，平均35．6岁。31例骨盆骨折按AO分类：B1型11例、B2型15例、B3型5例。术前摄骨盆CR片及骨盆前后环螺旋CT扫描，进行容积重建及横断面、冠状面、矢状面重建和骶骨曲面重建检查，其中隐匿性后环损伤28例。应用该技术结合经皮植骨骶髂关节融合术治疗5例骶髂关节炎，2例骶骨囊性病变。结果：术中失血25-70ml，平均36ml。38例均获得随访，时间3～39个月，平均15．6月。无感染、骨折不愈合、医源性神经血管损伤及内植物断裂、滑脱等并发症。依据骨盆创伤疗效标准，术后影像学评价优34例，良4例；临床评价优32例，良6例。结论：对于骶髂关节痛损，经皮空心骶髂拉力螺钉LX内固定技术安全可靠、手术创伤小、并发症少、生物力学稳定性好、康复快。

Percutaneous lag screw internal fixation of LX technique for the sacroiliac joint injury

Objective: To study the percutaneous lag screw internal fixation of LX technique for sacroiliac joint diseases or injuries. Methods: There were 38 patients(25 male and 13 female) with an average age of 35.6 years ranged from 18 to 59 years. Among them,thirty-one cases with trauma of Tile B type,five cases with sacroiliitis and two cases with sacral cystis degeneration. There were 11,15,5 cases of Tile B1,B2,B3 type respectively. Pelvic anterior-posterior radiography and spiral computed tomography(CT) were undertaken for all patients. Axis planar,coronal planar,sagittal planar and curve planar of sacral reconstruction of spiral CT images were obtained for every patient. There were 28 cases with delitescence posterior ring injury. All these patients were performed percutaneous lag screw fixation procedures of LX technique under epidural anesthesia. Localization with spiral CT guidance was performed by the radiologist using spiral CT followed by the orthopaedic surgeon. Percutaneous fusion of sacroiliac joint was performed for seven patients who suffered from sacroiliac joint diseases. Results: The blood loss were from 25 to 70 ml(means 36 ml) during operation. All patients were followed up for 3 to 39 months(means 15.6 months). There were no postoperative compilcations such as infection, fracture nonunion,iatrogenic injuries of nerve and blood vessel,breakage and slippage of fixtors. According to the evaluation of pelvic injuries,the results of imageology were excellent in 34 cases and good in 4,the results of clinical were excellent in 32 and good in 6. Conclusion: Percutaneous lag screw internal fixation of LX technique minimizes operation injury during a short procedure with few subsequent complications and allows early mobilization of the patients. That is an ideally safe and effetive operation technique for the sacroiliac joint diseases and injuries.