不稳定骨盆骨折61例手术治疗分析

目的探讨不稳定骨盆骨折的手术治疗。方法耻骨联合分离或耻骨支骨折采用耻骨联合上弧形切口或腹股沟切口,用重建钢板或螺钉固定。髂骨骨折及骶髂关节脱位、骶骨骨折采用骶髂后入路或前入路,用钢板、拉力螺钉、骶骨棒固定。结果本组61例得到随访,平均随访23个月。复位按照Matta评定标准优良率为88.6%。按照Majeed的疗效评价标准优良率为77%。结论对不稳定骨盆骨折的治疗,尽量选择早期手术切开复位及有效的内固定,可以获得骨盆外形恢复好、功能恢复快的效果。

Operative treatment of 61 cases of unstable pelvic fracture

Objective To investigate the effect of operative treatment of unstable pelvic fracture. Methods Arch skin incision above pubic symphysis or ilioinguinal approach were used in pubic symphysis separation or pubic branch fracture, and these fractures or dislocations were fixed with reconstruction plates or screws. Sacroiliac anterior or posterior approach were used in ilium fracture, sacral fracture or dislocation of sacroiliac joint ,and the fractures or dislocations were fixed with plates, tension screws or sacral rods. Results 61 patients were followed-up. The average times followed up were 23 months. 88.6% of the reductions were excellent or good according to Matta's criteria.77% were excellent or good according to Majeed's gradiography evaluation. Conclusion Open reduction and effective internal fixation should be performed for unstable pelvic fracture as possible as early so that the shape and function of pelvis can be effectively recovered.