不同微创内固定治疗骨盆前环骨折的疗效比较

目的：比较前柱螺钉、钢板和钉棒系统3种方式微创固定治疗骨盆前环骨折的临床疗效。方法：回顾性分析自2015年12月至2018年9月收治并获得完整随访的77例骨盆前环骨折患者，男45例，女32例，年龄19~73岁。按AO/OTA分型：B1型26例，B2型20例，B3型17例，C型14例。根据内固定方式不同分3组：前柱螺钉组35例，采用前柱螺钉内固定；钢板组20例，采用钢板内固定；钉棒系统组22例，采用钉棒系统内固定。比较3组患者的手术时间、术中透视次数、术中出血量、骨折复位质量、并发症发生情况及疗效等。结果：77例患者均获得随访，时间12~33（16.5±5.7）个月。前柱螺钉组手术时间、术中出血量及手术切口长度明显小于钢板组和钉棒系统组，钢板组术中透视次数明显少于前柱螺钉组和钉棒系统组（P<0.05）。3组患者术后骨折复位质量和疗效评价比较差异无统计学意义（P>0.05）。3组并发症发生比较差异有统计学意义（P<0.05）。。结论：前柱螺钉、钢板和钉棒系统微创内固定治疗骨盆前环骨折均可获得良好的临床疗效，但是前柱螺钉固定创伤更小、手术并发症发生率更低。

Comparison of different minimally invasive internal fixation in the treatment of pelvic anterior ring fracture

Objective: To compare the clinical efficacy of three minimally invasive methods of anterior column screw,plate and screw rod system in the treatment of anterior pelvic ring fracture. Methods: From December 2015 to September 2018,77 patients with pelvic anterior ring fracture were treated and followed up,including 45 males and 32 females,aged 19 to 73 years. According to AO/OTA classification,there were 26 cases of type B1,20 cases of type B2,17 cases of type B3 and 14 cases of type C. According to the different internal fixation methods,they were divided into three groups:anterior column screw group(35 cases),plate group(20 cases),and screw rod system group(22 cases). The operation time,intraoperative fluoroscopy times,blood loss,fracture reduction quality,complications and curative effect of the three groups were compared. Results: All 77 patients were followed up for 12 to 33(16.5±5.7) months. The operation time,intraoperative blood loss and incision length of anterior column screw group were significantly shorter than those of plate group and screw rod system group,and intraoperative fluoroscopy times of plate group were significantly less than those of anterior column screw group and screw rod system group(P<0.05). There was no significant difference in the quality of fracture reduction and curative effect among the three groups(P>0.05). The incidence of complications was significant different among three group(P<0.05). Conclusion: Minimally invasive internal fixation with anterior column screw,plate and screw rod system can obtain good clinical effect,but anterior column screw fixation has less trauma and lower incidence of surgical complications.